Thrombocytopenia in Pregnancy

Abstract

Objective: To study the proportion of thrombocytopenia in normal pregnancy, compare it with thrombocytopenia in pregnancy with associated complications. It was also to study maternal and fetal outcomes in pregnancies associated with thrombocyte-openia. Materials and Methods: In this study, 76 pregnant women were recruited from Department of Obstetrics and Gynecology, Gandhi hospital from August 2012 to October 2014. Antenatal women were enrolled in the study at first visit, irrespective of gestational age. Details were entered in the proforma. All women had platelet count estimation at the time of enrollment. Women with normal platelet count before 28 weeks had a repeat platelet count in third trimester to detect gestational thrombocytopenia. All the thrombocytopenic cases were followed up throughout the antenatal period till delivery to record any complications that developed due to low platelet counts. Later maternal and fetal outcomes were also recorded. Results: women were tabulated according to their demographic characteristics, gestational age at the time of first onset of thrombocytopenia, severity of thrombocytopenia and need for blood transfusion or requirement of any other intervention. The fetal and maternal outcomes were recorded. Conclusion: GT is the most common cause of thrombocytopenia during pregnancy (70%). If no antecedent history of thrombocytopenia is present and platelet counts are above 70,000/mcL, the condition is more likely to be GT. If platelet counts fall below 50,000/mcL or if a preexisting history of thrombocytopenia is present, the condition is more likely to be ITP. Follow platelet counts every 1-2 months or more frequently if the patient is symptomatic. Cesarean deliveries should be reserved for obstetrical indications only. With ITP, obtain cord blood at delivery for platelet count. For GT, document normalization of maternal platelet counts after delivery.