1. Acute ITP Since more than 80% of patients can recover on their own, some advocate the onset of acute infection and careful observation in those with mild bleeding. In view of the fact that 1% of children can die from intracranial hemorrhage, most people recommend that in cases of severe thrombocytopenia, prednisone treatment of 1 to 3 mg/kg per day should be given for a short period of time, which can lead to a rapid rise in platelets. 2, chronic ITP chronic type patients often have intermittent recurrent episodes. Various infections can aggravate platelet destruction, further reduce peripheral platelet count and intensify bleeding symptoms, so patients with chronic ITP should pay attention to the prevention of infection. (1) General supportive therapy: For those with severe occult bleeding, attention should be paid to rest and prevention of various traumas and intracranial bleeding. General hemostatic drugs such as Carbacrol (Anloha), tranexamic acid (hemostatic cyclic acid), bactrim (Lithoprim), etc. are available. Fresh blood can be transfused when bleeding is severe. It should be input within 6h after blood collection as it is appropriate to maintain 80% to 90% of platelet viability, while for those 24h after blood collection, its viability decreases significantly and is generally not suitable. (2) Glucocorticoids as the main drug for the treatment of ITP: Prednisone or corresponding doses of other hormones can be chosen. It has been reported that hormones can lead to remission in 10% to 15% of cases. In principle, the efficacy of hormones on ITP should be achieved by raising platelets to more than 100×109/L, but in practice, the clinical indicators that do not require long-term high-dose hormone therapy are usually based on the rise of platelets to more than 50×109/L and improvement of bleeding symptoms, and the above indicators are stable for more than 3 months as effective clinical treatment. In refractory cases, the dose of prednisone for the first application is 1 to 1.25 mg/kg. Based on a large amount of clinical data, it is believed that the degree of platelet count recovery in ITP patients is related to the size of the daily dose of prednisone. The efficacy was 45% for doses below 20 mg, 62% for doses between 21 and 39 mg, and 76% for doses above 40 mg. According to the clinical efficacy index of prednisone treatment, the general prednisone 1 to 3 days will start to improve, to 5 to 10 days can appear obvious effect. High-dose prednisone treatment, generally should not exceed 10 days, if the treatment for 10 days and the efficacy is still not satisfactory, even if the time of high-dose treatment is extended again may not have better results. The efficacy of hormones on ITP is not considered to be related to the patient’s age and gender, but rather to the timeliness of treatment. Most people believe that the earlier the treatment, the higher the rate of complete remission. The remission rate (complete remission and partial remission) is 50% to 80% for those treated within 3 months, 60% for those with a disease duration of about 1 year, and mostly ineffective for those with a disease duration of more than 4 years. A few cases have been seen clinically that have not achieved remission by prednisone treatment for more than half a year, and the platelets can gradually rise to more than 100×109/L by themselves 9-12 months after stopping the drug, the mechanism of which is unknown. (3) Splenectomy: It is one of the more effective methods to treat this disease. The indications for splenectomy are based on the clinical condition, generally for chronic ITP that has been ineffective by hormone therapy for more than 6 months, however, splenectomy can significantly increase the incidence of miscarriage, preterm delivery and fetal death. If the condition is not severe and other treatments are ineffective, surgery during pregnancy should generally be avoided as much as possible. (4) Immunosuppressive therapy: For chronic ITP that is ineffective after hormone and splenectomy or inappropriate for hormone and/or splenectomy, immunosuppressive drugs can be considered, mainly vincristine, azathioprine and cyclophosphamide. In principle, they are not used during pregnancy, so such drugs have toxic and teratogenic effects. (5) Danazol: It is a derivative of androgen and can be used in 10% to 60% of cases where other therapies are ineffective. The dose is 0.1~0.2g, 2~4 times/d. Platelets usually rise 2~6 weeks after the drug is administered, and the treatment can be maintained for 2~13 months. Small doses of hormones can be used during treatment, but they should not be applied during pregnancy. (6) High-dose immunoglobulin: Intravenous infusion of high-dose immunoglobulin can block the Fc receptor of the mononuclear macrophage system from binding to platelets, while single-molecule IgG antagonizes PAIgG in the mother and reduces PAIgG from entering the fetal blood circulation, so high-dose intravenous immunoglobulin given at any stage of pregnancy can improve the platelet count in the mother. It can effectively increase the fetal platelet count and prevent intracranial hemorrhage when given to pregnant women for several times, especially when given intravenous immunoglobulin one to two weeks before delivery, the pregnant women can bear vaginal delivery more often, even if the cesarean delivery is relatively safe, and the severity of neonatal thrombocytopenia is reduced. The usual dosage is 400 mg/kg per day, IV, for 5 days. The effect is usually seen in 1 to 2 days, but the effect is not long-lasting and expensive. (7) Chinese medicine treatment: such as amineptine, 1g each time, 3 times/d orally for 4 to 6 weeks. It is suitable for application during pregnancy. 3. Obstetric management In the face of pregnant women with ITP, the first question for clinicians is whether to terminate the pregnancy or to continue the pregnancy. When ITP occurs before pregnancy and the condition tends to deteriorate without remission during pregnancy, as well as severe ITP, which requires hormone therapy at the very beginning of pregnancy, termination of pregnancy should be considered. If the decision is made to continue the pregnancy, the treatment principles are the same as for simple ITP, to ensure normal fetal development.