Abstract / Summary
Fetal intracranial haemorrhage secondary to maternal systemic lupus erythematosus-associated immune thrombocytopenia is exceedingly rare and often catastrophic. Early recognition remains challenging. A 24-year-old women, gravida 3 para 0, with two prior spontaneous abortions and no live births, at 28 weeks and 2 days of gestation presented with lower abdominal pain and vaginal bleeding. She had a history of pregnancy-related thrombocytopenia that responded poorly to recombinant human thrombopoietin. On admission, her platelet count was 30 × 10^9/L and the blood pressure was 180/104mmHg, Fetal ultrasound revealed intracranial hemorrhage. Intravenous immunoglobulin and antihypertensive therapy were administered, but fetal demise occurred that evening. Subsequent autoantibody testing confirmed the diagnosis of SLE-associated ITP. In pregnant women with thrombocytopenia unresponsive to thrombopoietin receptor agonists, particularly those with a history of spontaneous abortion, early suspicion and targeted treatment of SLE-associated ITP are essential to prevent devastating fetal outcomes.