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Evidence summaries

Betamethasone for Idiopathic Thrombocytopenic Purpura during Pregnancy

Betamethasone might possibly not be useful for treating idiopathic thrombocytopenic purpura during pregnancy, but the evidence is insufficient. Level of evidence: "D"

A Cochrane review [Abstract] 1 included 1 study with a total of 38 women (41 pregnancies). Only 26 women (28 pregnancies) were analysed.Betamethasone (1.5 mg/day) compared with no medication found no statistically significant difference in neonatal thrombocytopenia (RR) 1.12, 95% CI 0.62 to 2.05) and neonatal bleeding (RR 1.00, 95% CI 0.24 to 4.13). An intention-to-treat analysis which showed similar findings: RR 1.18, 95% CI 0.57 to 2.45 and RR 1.05, 95% CI 0.24 to 4.61, respectively. Maternal death, perinatal mortality, postpartum haemorrhage and neonatal intracranial haemorrhage were not studied by this RCT.

Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment), high attrition rate and imprecise results (few patients and wide confidence intervals). .

    References

    • Martí-Carvajal AJ, Peña-Martí GE, Comunián-Carrasco G. Medical treatments for idiopathic thrombocytopenic purpura during pregnancy. Cochrane Database Syst Rev 2009 Oct 7;(4):CD007722. [PubMed]

Primary/Secondary Keywords