Maternal and fetal outcome of pregnancies complicated with thrombocytopenia

Abstract

Thrombocytopenia is defined as a platelet count below the lower limit of normal range (typically < 150,000/ microL). It is second only to anemia as the most common hematological abnormality encountered during pregnancy. Thrombocytopenia complicates about 7-8% of all pregnancies, especially in third trimester; it most frequently represents a complication not requiring treatment. Evaluation and management of thrombocytopenia during pregnancy and postpartum may be challenging because there are many potential causes, some directly related to pregnancy and some unrelated. For many causes there are no diagnostic laboratory tests.This topic reviews our approaches to determining causes of thrombocytopenia in a pregnant women and its impact on newborns while looking to stratify the risk according to etiology and severity of parturient’s hematological condition.In our study Gestational thrombocytopenia was the commonest cause of thrombocytopenia with incidence of 70%, followed by Preeclampsia (22%), HELLP (4%), ITP (2%) and Dengue (2%).Gestational thrombocytopenia is the commonest cause of thrombocytopenia and may not be related to adverse pregnancy outcome, thus can be treated as benign condition. Clinical assessment is most important factor for evaluating a patient with thrombocytopenia.Monitoring of platelet count of pregnant women should be a routine at antenatal visits for timely diagnosis and to achieve favorable feto- maternal outcome in all types of thrombocytopenia. Neonatal platelet count should be done in all mothers diagnosed with thrombocytopenia.After detailed evaluation of the data, we came to the conclusion that with proper care and precautions, readiness to deal with complications, thrombocytopenia does not pose significant impact on maternal and fetal morbidity and mortality when compared to normal population.