Anesthetic Experience of Cesarean Section in a Pregnant Woman with Immune Thrombocytopenic Purpura Having no Response to Treatment: A Case Report

A 36-year-old pregnant woman was admitted for an emergency cesarean section at a gestational age of 38 weeks. She exhibited an isolated low platelet count on routine screening at 35 weeks of gestation and was diagnosed with immune thrombocytopenic purpura (ITP). Unlike gestational thrombocytopenia, ITP is associated with severe thrombocytopenia and may lead to maternal as well as fetal morbidity and mortality. Thus, when administering anesthesia to pregnant women with ITP, anesthesiologists must account for the risk of maternal bleeding and fetal thrombocytopenia and closely monitor both the mother and fetus. The patient in this case exhibited severe thrombocytopenia with bleeding manifestations and was unresponsive to first-line therapy. Platelets were transfused until immediately before emergency cesarean section. Fortunately, surgery proceeded without notable maternal or fetal complications. Here, we report the anesthetic experience of a pregnant woman with ITP who was unresponsive to treatment and underwent cesarean section.