ObjectiveTo explore the causes, treatment, mode of delivery and neonatal situation about pregnancy with moderate-to-severe thrombocytopenia.Methods60 cases of pregnancy with moderate-to-severe thrombocytopenia were retrospectively analyzed.ResultsThe main cause of pregnancy with moderate-to-severe thrombocytopenia is idiopathic thrombocytopenia (ITP) 25 cases, for 41.7%; followed by gestational thrombocytopenia (GT) 20 cases, for 33.3%.The effectiveness of dexamethasone, dexamethasone + immunoglobulin and platelet transfusion respectively is 72.2%, 100%, 75%.There was significant diference of platelet count before and after different treatments (P<0.01).41 cases cesarean section, 19 cases vaginal delivery, postpartum hemorrhage 4 cases, there are all esist uterine atony.Analyze by Spearman correlation.There is a negative correlation between postpartum hemorrhage of cesarean cases and the platelet count after treatment(r=-0.376, P=0.015).Neonatal thrombocytopenia in 4 cases, mothers are the ITP, mother has a history of splenectomy in 2 cases and neonatal platelets are less than 10×109L-1, neonatal gastrointestinal bleeding and intracranial hemorrhage in 1 case.ConclusionITP and GT are the primary causes of pregnancy with moderate-to-severe thrombocytopenia.Dexamethasone, immunoglobulin and platelet transfusion are effective methods for treatment.Platelet after treatment is lower than 50×109 L-1 as well as obstetrical indications cesarean delivery, should have good contractions to prevent postpartum hemorrhage, treatments have certain prevention of hemorrhage in cesarean section.Newborn babies should be monitoring platelet of ITP pregnant childbirth, for pregnant women with a history of splenectomy should be fully informed of severe neonatal thrombocytopenia and the possibility of neonatal intracranial hemorrhage.