A Study of Maternal and Fetal Outcome of Thrombocytopenia in Pregnancy

Abstract

Background: Thrombocytopenia is found to complicate pregnancies in India. The major function of platelets is the initiation of haemostasis. Thrombocytopenia can result in spontaneous bleeding from any part of the body. It may be associated with serious bleeding at delivery and may require emergent maternal and neonatal care. Introduction: After anaemia, thrombocytopenia is the most frequently occurring hematologic disorder in pregnancy. It is found to complicate 7% to 8% of pregnancies in India. The major function of platelets is the initiation of haemostasis, and hence, thrombocytopenia can result in spontaneous bleeding from any part of the body. It may be associated with serious bleeding at delivery and may require emergent maternal and neonatal care. Thrombocytopenia is diagnosed if the platelet count 150 × 109/l, caused by increased platelet lysis or reduced inefficient production. Aims & Objectives: To study the maternal and fetal outcome of thrombocytopenia in pregnancy and to study some of the causes of thrombocytopenia in pregnancy. Methodology: Total 113 cases with maternal thrombocytopenia were included in present study after satisfying inclusion and exclusion criteria and followed till delivery. We studied maternal complications gestational age at delivery, indication of induction of labour and method (if required) and mode of delivery, NICU stay were recorded. Results: Majority of the patients i.e. 63 patients (55.8%) were in the age group of 20-25 years. Among 113 cases; primigravida (56 cases, 49.6%) and multigravida (57 cases, 50.4%) were almost equally distributed. Majority of the study population was diagnosed with Gestational thrombocytopenia 50.4% followed by severe pre-eclampsia 22.12%, HELLP syndrome 8.8%, abruption 5.3% antepartum eclampsia and dengue 2.7% each. Maternal mortality was seen in 2 cases (1.8%). Mean birth weight was found to be 2.45 Kgs. of 113 babies, neonatal mortality was seen in 15 cases, NICU admission was indicated in 18 babies and KMC care was needed for 1 baby. Conclusion: The most common cause of thrombocytopenia during pregnancy is Gestational Thrombocytopenia (GT) followed by pre-eclampsia, eclampsia and HELLP syndrome. With platelet counts above 70,000/ μLno prior history of thrombocytopenia the condition is more likely to be GT. The lack of well-defined symptomatology and clinical presentation makes early and accurate diagnosis difficult leading to delay in treatment.