Use of romiplostim in pregnancy for refractory idiopathic thrombocytopenic purpura: Two case reports with maternal and fetal outcomes and literature review

Su J. Chua, Mark R. Morton, John Svigos, David M. Ross, Simon Kane

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)


Idiopathic thrombocytopenic purpura is a relatively rare complication occurring in pregnancy, with the potential for serious maternal and fetal outcomes. Rarely, the poor response to established first-line therapies results in consideration of second-line therapies, which may have poorly understood risks to the fetus. We report two women with severe idiopathic thrombocytopenic purpura during pregnancy unresponsive to corticosteroids and intravenous immunoglobulin who were treated with romiplostim, a thrombopoietin receptor agonist. One woman with chronic idiopathic thrombocytopenic purpura had a partial response to romiplostim and suffered a post-partum haemorrhage related to uterine atony. The second woman developed severe idiopathic thrombocytopenic purpura in pregnancy and initially responded well to romiplostim. However, a lower segment Caesarean section was performed at 37 weeks for pre-eclampsia. The newborn suffered from severe idiopathic thrombocytopenic purpura and a grade 1 cerebral haemorrhage requiring intravenous immunoglobulin and platelet transfusions. Romiplostim might be a useful therapy for severe idiopathic thrombocytopenic purpura in pregnancy but requires further study.

Original languageEnglish
Pages (from-to)45-50
Number of pages6
JournalObstetric Medicine
Issue number1
Publication statusPublished or Issued - 1 Mar 2020
Externally publishedYes


  • Romiplostim
  • immune thrombocytopenic purpura
  • platelet transfusion
  • pregnancy
  • recombinant fusion protein
  • thrombopoietin receptor agonists

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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