Immune thrombocytopenia and pregnancy: challenges and opportunities in diagnosis and management.

Decreasedplatelet production may play a role in pregnancy-related ITP exacerbation.Putative mechanisms include placental hormones, such as inhibin. Although IVIGand prednisone usually suffice to achieve hemostasis for delivery, second-lineagents are sometimes required to allow for neuraxial anesthesia. There isgrowing evidence supporting the use of romiplostim during pregnancy; however,its risk of venous thromboembolism warrants further evaluation.