Gestational Thrombocytopenia Research Articles

Isolated thrombocytopenia in pregnancy: A monocentric retrospective study of 63 pregnancies in 59 women

AbstractThrombocytopenia during pregnancy is often thought to be associated with severe bleeding manifestations. Three are the main disorders associated with this condition: gestational thrombocytopenia (GT), immune thrombocytopenia (ITP), and inherited thrombocytopenias (ITs). Reaching the correct diagnosis of this condition has relevant therapeutic and outcome implications. We performed a retrospective, observational, monocentric study enrolling 59 consecutive women with isolated thrombocytopenia, attended to our referral center in the last 3 years. Together with personal and family history, platelet (PLT) count trend and mean platelet volume (MPV) in pregnancy are helpful for the diagnosis, with the highest PLT count in GT and lowest in ITs, with different timing of count decrease. MPV is significantly increased in both ITs and ITP. Misdiagnosis with ITP was responsible for unnecessary and unsuccessful therapy in some GT or ITs pregnant women, determining relevant side effects. Excluding inherited platelet function disorders (IPFDs), the bleeding risk for mother with thrombocytopenia and their newborns is similar to the general population. Vaginal delivery is associated with a lower risk of bleeding than cesarean section and therefore is preferable whenever obstetrical–gynecological conditions permit.

Fetomaternal Outcome in Pregnancy with Gestational Thrombocytopenia

Introduction: Gestational thrombocytopenia, a common hematological disorder in pregnancy, poses risks to both maternal and neonatal health. This study aims to evaluate the fetomaternal outcomes in pregnancies complicated by gestational thrombocytopenia compared to those with normal platelet counts. Methods: This prospective cohort study was conducted over 12 months at Jalalabad Ragib-Rabeya Medical college hospital sylhet Bangladesh. It included 100 pregnant women diagnosed with gestational thrombocytopenia (platelet count <150,000/µL after 20 weeks of gestation) and 100 matched controls with normal platelet counts. Maternal data included demographic information, obstetric and medical history, mode of delivery, incidence of pre-eclampsia, postpartum hemorrhage, and need for platelet transfusions. Fetal outcomes assessed were birth weight, Apgar scores, preterm birth rates, NICU admissions, and neonatal thrombocytopenia. Data were analyzed using t-tests for continuous variables and chi-square tests for categorical variables, with multivariate logistic regression to identify predictors of adverse outcomes. Result: The gestational thrombocytopenia group showed higher, though not statistically significant, rates of cesarean delivery (30% vs. 25%, p=0.453), pre-eclampsia (15% vs. 12%, p=0.540), and postpartum hemorrhage (18% vs. 10%, p=0.110). Platelet transfusions were required more frequently in the gestational thrombocytopenia group (8% vs. 2%, p=0.052). Fetal outcomes revealed lower mean birth weight (2950g vs. 3050g, p=0.145), higher preterm birth rates (14% vs. 10%, p=0.371), and more NICU admissions (20% vs. 12%, p=0.132) in the gestational thrombocytopenia group. Notably, neonatal thrombocytopenia was significantly more prevalent in the gestational thrombocytopenia group (10% vs. 2%, p=0.017). Conclusion: Gestational thrombocytopenia is associated with increased risks of certain maternal and neonatal complications. Vigilant monitoring and management are essential to improve outcomes in affected pregnancies. Further research is needed to develop targeted interventions and improve antenatal care practices.

Clinical Characteristics and Outcomes of Intrauterine Blood Transfusion (IUT) for Infectious Etiologies.

Congenital viral infection may result in fetal anemia and thrombocytopenia. While intrauterine blood transfusions (IUTs) are more commonly performed for Rh alloimmunization, reports using IUT for infection have varying success. Our primary objective was to characterize the outcomes of patients undergoing IUT for infectious etiologies at our center compared with Rh disease. This was a case series of patients undergoing IUT from 2012-2023. Infectious etiologies were identified by maternal serologies and confirmed by amniotic fluid polymerase chain reactions (PCR). Clinical outcomes were obtained from electronic medical records. During the study period, 70 patients underwent IUT, 34% (24/70) for Rh alloimmunization and 17% (12/70) for infection. Those with infectious etiologies were more likely to be diagnosed at earlier gestational ages (22 vs. 25weeks, p=0.04), with hydrops (75 vs. 33%, p=0.03), and thrombocytopenia (27±33×103 vs. 163±112×103, p<0.01). Perinatal death was significantly greater in cases of CMV (4/5, 80%) compared to parvovirus (1/7, 14%) or Rh alloimmunization (5/24, 21%) (p=0.02). Anemias and thrombocytopenias related to fetal infection may be indications for IUT. Compared with Rh alloimmunization, IUT in fetal infections was performed significantly earlier, and hydrops were more common at the time of IUT. In the case of CMV, greater rates of IUFD (80%) were observed. Patients should be counseled on the various outcomes by indication.

Oedematous malnutrition among admitted low birth weight neonates receiving parenteral feeding in selected hospitals in Ethiopia

AbstractBackgroundOedematous malnutrition is a severe form of malnutrition characterized by generalized swelling, fluid retention and nutritional deficiencies, which affects preterm and low‐birth‐weight (LBW) infants significantly. However, there is limited data among LBW neonates in low‐income countries.ObjectiveTo identify the prevalence and factors associated with oedematous malnutrition among LBW neonates receiving parenteral feeding in the neonatal intensive care unit (NICU) of public hospitals in Addis Ababa City.MethodsAn institution‐based cross‐sectional study was conducted from March to June 2022. A multistage sampling technique was utilized to select samples, and a pretested questionnaire and checklist were used to collect the data. Bi‐variable and multivariable logistic regression were done to identify factors associated with oedematous malnutrition. Statistical significance was declared at a p‐value less than 0.05.ResultTwo hundred eighty‐nine LBW neonates receiving parenteral feeding were evaluated for oedematous malnutrition, of which 27 (9.34%) neonates developed it. Gestational age less than 32 weeks (adjusted odd ratios [AOR]: 6.74 95% CI: 1.456−31.27) and above 37 weeks (AOR: 12.36 95% CI: 1.44−105.69), thrombocytopenia (AOR: 4.208 95% CI: 1.12−15.78), receiving parenteral feeding for 7−14 days (AOR: 8.61 95% CI: 1.33−55.52) and more than 14 days (AOR: 21.10 95% CI: 2.89−153.94) were significantly associated with oedematous malnutrition.ConclusionThis study identified that a significant number of neonates developed oedematous malnutrition, and gestational age, thrombocytopenia and length of admission had a significant association with oedematous malnutrition among LBW neonates. It is crucial to reevaluate the quality of care in the NICU and implement an improvement project to decrease the length of parenteral feedings.

Case Description: “Are You Sure the Platelet Count is Only 2???” Cesarean Section in the Setting of Severe Thrombocytopenia

Gestational thrombocytopenia, preeclampsia, and immune thrombocytopenia are commonly recognized etiologies of low platelet counts representing the vast majority of encountered gestational cases (86-100%). However, there are many other rare causes. The following case details a patient with three prior pregnancies, each remarkable for profound unexplained thrombocytopenia, which promptly normalized following delivery. It further details her fourth pregnancy, similar thrombocytopenia, an investigation into the causes, balancing platelet transfusion against the risk of alloimmunization, in-hospital treatment, and her eventual anesthetic, resuscitation, and delivery.

CLINICO-INVESTIGATIVE PROFILE OF THROMBOCYTOPENIA IN THIRD TRIMESTER OF PREGNANCY

Background:Thrombocytopenia often occurs in pregnancy, ranking as the second most common hematologic abnormality following anemia. It affects approximately 6% to 10% of pregnant women.1 This research aimed to explore the factors linked to thrombocytopenia among rural Indian women in their third trimester of pregnancy. Methods:This prospective observational study was conducted at Dr.BalasahebVikhePatil Rural Medical College and Dr.VitthalraoVikhePatilsPravara Rural Hospital in India. The study specifically targeted rural Indian women in their third trimester of pregnancy with a platelet count below 150,000 per cubic millimeter. Results:In the present study, among the 86 cases examined, the largest proportion (44.2%) were diagnosed with Gestational Thrombocytopenia, followed by 27.9% diagnosed with hypertensive disorders of pregnancy and 16.3% with HELLP syndrome. Among the 39 cases of gestational thrombocytopenia, 41.01% were categorized as mild thrombocytopenia. Of the 38 cases of hypertensive disorders of pregnancy accompanied by thrombocytopenia, 63% were associated with pre-eclampsia and 36.8% with HELLP syndrome. Additionally, 61.6% of the babies were born with low birth weight, and 73.5% of these cases were linked to maternal platelet counts below 100,000 per cubic millimeter.. Conclusions:The research underscores gestational thrombocytopenia as the leading cause during the third trimester, followed by hypertensive disorders such as pre-eclampsia and HELLP syndrome. It emphasizes the need for careful monitoring, particularly for first-time mothers and those in their third trimester, due to increased risks. The link between maternal platelet count and neonatal outcomes, particularly low birth weight, highlights the complex relationship between maternal health and fetal well-being.

Does Gestational Thrombocytopenia and Immune Thrombocytopenic Purpura Warrant Hospital Admission?

Does Gestational Thrombocytopenia and Immune Thrombocytopenic Purpura Warrant Hospital Admission?

Immune thrombocytopenia (ITP) in pregnancy.

Immune thrombocytopenia (ITP) in pregnancy is challenging for both mother and fetus. Understanding the pathophysiology, treatments, and risks to the mother and fetus leads to proper management resulting in successful pregnancy and delivery in almost all cases.1 ITP in a pregnant woman has many similarities to ITP not in pregnancy although gestational thrombocytopenia can be confused with ITP. However, recognizing differences is instrumental in avoiding bleeding complications and toxicities of treatment. This Nutshell review focuses on the natural history of ITP in pregnancy, its treatment, and dilemmas.

Understanding and Managing Thrombocytopenia in Pregnancy: A Case Series

Thrombocytopenia, defined as a platelet count of less than 1.5 L/mm3 , is a common haematological disorder encountered during pregnancy. It can arise from a variety of causes, including immune-mediated destruction, gestational thrombocytopenia, and underlying medical conditions such as preeclampsia or Haemolysis, Elevated Liver Enzyme Levels and Low Platelet (HELLP) syndrome, with gestational thrombocytopenia being the most common. Hereby, the authors present a case series including six patients with thrombocytopenia in pregnancy. The clinical characteristics, diagnostic work-up, management strategies, and maternal and foetal outcomes in patients with varying aetiologies of thrombocytopenia were described in present series. Understanding the aetiology and management of thrombocytopenia in pregnancy is crucial for optimising maternal and foetal outcomes, and this series contributes valuable clinical insights into this important area of obstetric haematology. It underscores the need for a multidisciplinary approach in managing complex obstetric cases involving thrombocytopenia and other co-morbidities. Effective collaboration among obstetricians, haematologists, physicians, and specialists is essential for addressing the challenges of thrombocytopenia during pregnancy and achieving the best outcomes for both mother and baby.

Evaluation of maternal and fetal outcomes in pregnant women with gestational thrombocytopenia

Evaluation of maternal and fetal outcomes in pregnant women with gestational thrombocytopenia

Genetic basis of pregnancy-associated decreased platelet counts and gestational thrombocytopenia

AbstractPlatelet count reduction occurs throughout pregnancy, with 5% to 12% of pregnant women being diagnosed with gestational thrombocytopenia (GT), characterized by a more marked decrease in platelet count during pregnancy. However, the underlying biological mechanism behind these phenomena remains unclear. Here, we used sequencing data from noninvasive prenatal testing of 100 186 Chinese pregnant individuals and conducted, to our knowledge, the hitherto largest-scale genome-wide association studies on platelet counts during 5 periods of pregnancy (the first, second, and third trimesters, delivery, and the postpartum period) as well as 2 GT statuses (GT platelet count < 150 × 109/L and severe GT platelet count < 100 × 109/L). Our analysis revealed 138 genome-wide significant loci, explaining 10.4% to 12.1% of the observed variation. Interestingly, we identified previously unknown changes in genetic effects on platelet counts during pregnancy for variants present in PEAR1 and CBL, with PEAR1 variants specifically associated with a faster decline in platelet counts. Furthermore, we found that variants present in PEAR1 and TUBB1 increased susceptibility to GT and severe GT. Our study provides insight into the genetic basis of platelet counts and GT in pregnancy, highlighting the critical role of PEAR1 in decreasing platelet counts during pregnancy and the occurrence of GT. Those with pregnancies carrying specific variants associated with declining platelet counts may experience a more pronounced decrease, thereby elevating the risk of GT. These findings lay the groundwork for further investigation into the biological mechanisms and causal implications of GT.

De Novo ITP Diagnosed during Pregnancy : Outcome for the Mothers and the Neonates and Prospective Comparative Study with Chronic ITP Pregnant Women

Background and Objective : Outcome, severity and transition to chronic illness of de novo ITP diagnosed during pregnancy and incidence of neonatal ITP (NITP) in this subset of patients have never been prospectively described. We conducted a prospective multicentric study in France to evaluate the outcome of patients with ITP during pregnancy (Clinical Trials.gov ID NCT02892630). One of the aims of this study was to investigate the evolution of ITP in patients with known ITP prior to pregnancy (« chronic group »). The results of this first part of the study have been recently published (Guillet et al, Blood ; 141 :11-21). Another aim was also to prospectively study the outcome of patients with ITP appeared and diagnosed during pregnancy (“ de novo group”) and to compare them with the previous group. We report the results here. Methods: De novo ITP was defined by a normal platelet count before pregnancy and a nadir &amp;lt; 50x10 9/L during pregnancy without any other clinical or biological abnormalities in particular no sign of pregnancy-specific causes of thrombocytopenia. We used a stringent platelet count threshold &amp;lt;50x10 9/L to avoid misdiagnosis with gestational thrombocytopenia. Patients were followed during pregnancy and 6 months after delivery. We compared ITP outcome in both groups (“ chronic” and “ de novo” groups) including episodes of bleeding events, severe thrombocytopenia (&amp;lt;30x10 9/L) and ITP treatment modification. We also studied obstetrical complications and NITP incidences in both groups. Results: 34 “ de novo” ITP women diagnosed during pregnancy were included and compared with 61 chronic ITP pregnant women. De novo ITP was diagnosed equally during the first, second and third trimester, in respectively 29.4% (10/34), 32.4% (11/34) and 38.2% (13/34). Among these 34 women, 29.4% (10/34) were primiparous. De novo ITP pregnant women experienced during follow-up, severe thrombocytopenia in 50% [35.5-91.9], bleeding events in 41.2% [26.8-59.4] including 11.8% [4.6%-28.4%] severe bleeding events with a French bleeding score &amp;gt; 8 and ITP therapeutic interventions in 76.5% [61.4-88.9]. Episodes of severe thrombocytopenia and bleeding events including severe bleeding event were similarly observed in “ de novo” and “ chronic” groups (data not shown). However, chronic ITP pregnant women underwent less ITP therapeutic interventions 50.8% [39.1-63.8], p=0.039. Obstetrical complications including preterm delivery, postpartum hemorrhage and cesarean delivery rates were similar in both groups (data not shown). NITP &amp;lt;50x10 9/L was observed in 6/31 (19.3%) neonates of women with de novo ITP and was similar to those observed in neonates of chronic ITP women 9/53 (17%). With a median follow-up of 6 months [5-7] after delivery, de novo ITP remained active for 25/34 women (73.5%). Conclusion: The severity of de novo ITP diagnosed during pregnancy and the risk of NITP are closely similar to those observed in chronic ITP pregnant women. Non-fatal severe bleeding events occur in around 10% of patients. De novo ITP remains active 6 months after delivery in a large majority of patients. Our study is still in progress to better assess the risk of chronic evolution (more than one year of duration) of de novo ITP after delivery.

Maternal and Neonatal Outcomes of Gestational Thrombocytopenia in Pregnant Women from Kirkuk City, Iraq: A Case-Control Study

Background: Thrombocytopenia is the most common hematological disorder in pregnant women, second only to anemia. A platelet count of less than 150x109/L is regarded as low. It is the most common cause of thrombocytopenia during pregnancy when the platelet count does not fall below 70x109\L. Methods: A case-control study was carried out in the department of obstetrics and gynecology at Azadi Teaching Hospital, Kirkuk, Iraq. Two hundred pregnant women were enrolled in the study; they were divided into 100 cases and 100 controls. All participants were in labor at the time of admission. The cases were pregnant women with gestational thrombocytopenia, while the controls were pregnant women with a normal platelet count. A platelet count was performed for all participants using the Swelab Alfa Plus system. Results: mean gestational age and platelet count were significantly lower in patients than controls, while there was no statistically significant difference in age or parity between the study groups. Preterm labor, postpartum hemorrhage (PPH), intrauterine fetal growth restriction (IUGR), and intrapartum fetal distress were significantly higher in the patients than in the controls, and the mean APGAR score at 5 minutes was significantly lower in the patients compared to the controls. Conclusions: Pregnant women with gestational thrombocytopenia may be at higher risk of preterm labor, postpartum hemorrhage, IUGR, intrapartum fetal distress and a low neonatal APGAR score.

Platelet Count Response to Obstetrical Use of IVIG for Maternal Thrombocytopenia: A 14-Year Retrospective Study

Introduction: Thrombocytopenia affects approximately 10% of pregnant individuals with Gestational Thrombocytopenia (GT) accounting for 80% of cases and Immune Thrombocytopenia (ITP) representing 3% of cases. Distinguishing between GT and ITP is challenging, leading to many pregnant individuals with moderate thrombocytopenia receiving treatment for ‘possible ITP’ with Intravenous Immunoglobulin (IVIG) in attempt to raise platelet counts (PLT) for safe labor and delivery and to potentially allow for neuraxial anesthesia. However, evidence on the impact of IVIG on PLT during pregnancy remains limited, and predictive factors for IVIG response are lacking. We aim to investigate the effect of IVIG on PLT in pregnant individuals with moderate thrombocytopenia (PLT &amp;lt; 100 x 10 9/L). The specific objectives are to assess the incremental response in maternal PLT following IVIG administration, the proportion of PLT exceeding 80 x 10 9/L after IVIG administration, the proportion of incremental increase in PLT by more than 20 x 10 9/L following IVIG administration, and to identify factors associated with these outcomes. Methods: We conducted a retrospective cohort study using administrative and chart review data between 2007-2020. We included all pregnant individuals who received IVIG for moderate thrombocytopenia. Data collected encompassed parameters such as age, gestational age at delivery, platelet counts at various timepoints, highest immature platelet fraction (IPF) during pregnancy, IVIG dose and frequency, hemoglobin levels, transfusions, and corticosteroid use. Data were analyzed using descriptive statistics. Paired t-test was used to compare means of PLT pre- and post-IVIG administration. Simple logistic regression was used to assess predictors of PLT ≥ 80 x10 9/L and PLT increment ≥ 20 x10 9/L post-IVIG. Results: Out of 651 deliveries with moderate thrombocytopenia, 79 (12.1%) received IVIG for a total of 4,527.50 grams and a median dose of 60 g (IQR: 30 - 77.5). Excluding 22 pregnancies due to other interventions such as platelet transfusions (n=12), corticosteroids (n=7), or both (n=3), 57 remained for analysis. The median incremental response in PLT following IVIG administration was 27 x10 9/L (IQR: 3-94). Pre-IVIG PLT median was 65 x10 9/L (IQR: 48-73), and post-IVIG PLT median was 98 x10 9/L (IQR: 69-142). PLT increment ≥ 20 x 10 9/L following IVIG was observed in 54.4% (31/57) of deliveries, and 57.9% (33/57) of deliveries achieved PLT ≥ 80 x 10 9/L following IVIG administration. Mean PLT post-IVIG (M = 112.51 x10 9/L, SD 55.88) were significantly greater than pre-IVIG PLT (M = 59 x10 9/L, SD = 19.71) by 53.51 points, p = &amp;lt; .001. Nadir PLT &amp;lt; 30 in pregnancy was associated with a statistically significant increase in PLT ≥ 80 x10 9/L following IVIG (odds ratio (OR) = 6.29, 95% confidence interval (CI) = 1.25-31.51, p &amp;lt; 0.05) and PLT increment ≥ 20 x10 9/L (OR = 7.58, 95% CI = 1.51-38.05, p &amp;lt; 0.05). An IPF &amp;lt; 16% was also associated with a statistically significant increase in PLT ≥ 80 x10 9/L (OR = 4.85, 95% CI = 1.08-21.76, p &amp;lt; 0.05) and PLT increment ≥ 20 x10 9/L (OR = 4.85, 95% CI = 1.08 - 21.76, p &amp;lt; 0.05). Moreover, a post-IVIG PLT increment ≥ 20 x10 9/L was positively associated with pre-IVIG PLT below 50 x10 9/L (OR = 8.67, 95% CI = 1.73 - 43.33, p &amp;lt; 0.05), but negatively associated with PLT 70-100 x10 9/L (OR = 0.18, 95% CI = 0.05 - 0.57, p &amp;lt; 0.05). For post-IVIG PLT ≥ 80 x10 9/L, there were no statistically significant relationships with gestational age, maternal age, pre-pregnant PLT or pre-IVIG PLT. Similarly, for post-IVIG PLT increment ≥ 20 x10 9/L, there were no statistically significant relationships with GA, maternal age, pre-pregnant PLT, or a pre-IVIG PLT between 50-69 x10 9/L. Conclusions: IVIG administration shows promising results for pregnant individuals with moderate thrombocytopenia. The study highlights the importance of nadir PLT in pregnancy, IPF levels, and pre-IVIG PLT as potential factors influencing the response to IVIG treatment. Our study is limited by its retrospective and single-centered design, and small sample size. Nevertheless, these findings generate hypotheses and could inform future prospective multicenter studies to optimize IVIG administration in this setting, considering its effectiveness and potential risks while minimizing costs.

Associations between the size and duration of asymptomatic subchorionic hematoma and pregnancy outcomes in women with singleton pregnancies

BackgroundThe purpose of this study was to investigate the relationship between the size and duration of asymptomatic subchorionic hematoma and pregnancy outcomes in women with singleton pregnancies.MethodsThis was a retrospective study that enrolled 701 singleton pregnant women who were diagnosed with asymptomatic subchorionic hematoma by ultrasound at 5–10 gestational weeks. The control group recruited 640 normal pregnant women without subchorionic hematoma who were matched with subchorionic hematoma group on baseline characteristics. The pregnancy outcomes were compared between the two groups, and the associations of the size and duration of subchorionic hematoma with pregnancy outcomes were analyzed by logistic regression model.ResultsCompared with the normal pregnancy group, the incidence of, gestational diabetes mellitus, gestational thrombocytopenia, placenta adhesion, fetal growth restriction, macrosomia in subchorionic hematoma group were higher (all P < 0.05). After adjusting for confounding factors, the hematoma size was positively associated with the occurrence of gestational hypothyroidism (adjusted OR[95%CI]: 1.029[1.004–1.054]), intrahepatic cholestasis of pregnancy (adjusted OR[95%CI]: 1.095[1.047–1.146]), term premature rupture of membranes (adjusted OR[95%CI]: 1.044[1.005–1.085]), hypertensive disorders of pregnancy (adjusted OR[95%CI]: 1.030[1.0004-1.060]), gestational thrombocytopenia (adjusted OR[95%CI]: 1.078 [1.045–1.113]), placenta adhesion (adjusted OR[95%CI]: 1.054 [1.027–1.082]), and the duration of hematoma was positively associated with the incidence of term premature rupture of membranes (adjusted OR[95%CI]: 1.070[1.027–1.115]), gestational diabetes mellitus (adjusted OR[95%CI]: 1.938 [1.886–1.993]) and fetal growth restriction (adjusted OR[95%CI]: 1.194 [1.124–1.268]).ConclusionsThe presence, size and duration of a first-trimester asymptomatic subchorionic hematoma may be associated with adverse pregnancy outcomes at later gestations such as term premature rupture of membranes and fetal growth restriction.

Prevalence of Gestational thrombocytopenia in five cities of India: A cross sectional descriptive study

: Pregnancy is a wonderful event of a women life, where in a female prepare herself to give birth to child. The physiological changes in blood include a rise in erythrocytes and a decrease in platelets, which results in the condition known as thrombocytopenia, where the platelet counts are fewer than a few lakhs and bring on bleeding symptoms. The decreased platelet during pregnancy is called gestational thrombocytopenia. : The present study aims to find the prevalence of the gestational thrombocytopenia in India. A cross sectional descriptive study design used to identify the prevalence rate of the gestational thrombocytopenia in India, total 3952 samples from India like Lucknow, Panipat, Sonipat, Gohana, Delhi. The study found that the prevalence of gestational thrombocytopenia is 3.4%. During the study period records revealed that 37 women (27%) belonged to gestational age of 30-33 weeks, 30 women (21%) belonged to gestational age of 34-36 weeks and 70 women (51%) belonged to gestational age of 37-40 weeks. Thirty-five (25.5%) cases had mild thrombocytopenia, 22 women (16%) had moderate, and 80 women (58.7%) had severe thrombocytopenia.: The present study assessed the prevalence of the gestational thrombocytopenia at various cities in India, suggested the importance of the early identification of gestational thrombocytopenia and prevention of complications related to gestation and pregnancy outcome

Hypertension in Pregnant Females Promotes Thrombocytopenia

Objective: To determine how often pregnant hypertensive women get thrombocytopenia during the pregnancy. Study Design: Retrospective study Place and Duration: People university of Medical and Health Sciences for Women Nawabshah. January 2022 to December 2022. Methods: Total 63 pregnant females were presented. All the presented females had pregnancy induced hypertension with age group 18-46 years. All cases included platelet estimate, and thrombocytopenia was diagnosed in individuals with a reported platelet count of less than 1,50,000/cumm. All data were analyzed with SPSS 24.0. Results: Pregnant females had mean age 28.6±4.35 years and had mean BMI 26.4±3.29 kg/m2. Frequency of primigravida was 27 (42.9%) and 36 (57.1%) cases were multi-gravida. Majority of the patients 55 (87.3%) had blood pressure 140-160/90-110 mmHg and 8 (12.7%) cases had Bp &gt; 160/110 mmHg. Frequency of thrombocytopenia was found in 17 (26.98%) cases. Among 17 cases of thrombocytopenia mild PIH was found in 3 cases, moderate in 5 cases and 8 cases had severe PIH. Conclusion: In particular, in third-trimester hypertensive pregnant women, gestational thrombocytopenia (GT) is recognized as a primary cause of thrombocytopenia. For those women, careful monitoring both during and after pregnancy is advised. Keywords: Thrombocytopenia, Gestational hypertension, Pregnancy

Випадок тяжкої імунної тромбоцитопенії під час вагітності

Immune thrombocytopenia (ITP) is one of the most common causes of thrombocytopenia (TP) in pregnancy and is the main cause of severe TP among pregnant women. Autoimmune pathogenesis determines the danger of hemorrhagic complications both for the pregnant and for the fetus and newborn. Differential diagnosis between gestational and immune thrombocytopenia is necessary, as this determines further tactics. The goal of ITP treatment is to achieve a safe level of platelets according to the gestational age and clinical situation. For treatment, different lines of therapy are used alternately with step-by-step control of effectiveness. Purpose - to analyze the worldwide and personal experience of pregnancy management in severe ITP refractory to treatment. We present a case of pregnancy management and delivery with a severe immune thrombocytopenia, diagnosed at 25 weeks of pregnancy with hemorrhagic syndrome, unresponsive to treatment. All pharmacological tools were used. Delivery by caesarean section with appropriate preoperative and intraoperative transfusion preparation. Recombinant human thrombopoietin was used in the postoperative period. The newborn has thrombocytopenia without hemorrhagic syndrome. Conclusions. Correct diagnosis of conditions accompanied by thrombocytopenia during pregnancy determines the correct and effective treatment tactics. Pregnancy and childbirth in women with severe thrombocytopenia belong to the group of extremely high risk. Antenatal management and delivery of such pregnant women should be carried out by a multidisciplinary team with the participation of a hematologist, a specialist in internal medicine, under careful control of laboratory indicators and clinical changes, with control of the fetal antenatal condition. It is necessary to control the platelet level of the newborn in the postnatal period. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Prevalence of Thrombocytopenia in Women during Third Trimester of Pregnancy

Objectives: To determine the prevalence of thrombocytopenia in women during third trimester of pregnancy. Study Design: Cross-sectional study. Place and Duration: Department of Obstetrics and Gynaecology Department, District Headquarter Hospital, Gujranwala, from April 2022 to October 2022. Methodology: Women with third trimester of pregnancy (aged 18-45 yeas) were analyzed. Two milliliters of venous blood was collected and sent to institutional laboratory for complete blood count evaluation. Frequency of thrombocytopenia was noted. Thrombocytopenia was defined as the platelets count &lt;150×106/mm3. Results: In a total of 150 women, the mean age was 28.17±4.61 years and 101 (67.33%) women were aged between 18-30 years. The mean gestational age was 32.88±1.78 weeks while the mean parity was 2.84±1.02. The mean platelets count was 213×106/mm3±78.33×106/mm3. Thrombocytopenia in women during third trimester of pregnancy was found in 15 (10.0%) women. Practical Implications: Early detection of gestational thrombocytopenia and careful calculation of risks and preemptive management can be done in order to reduce the fetomaternal morbidity and mortality of patients. Conclusion: The prevalence of thrombocytopenia in women during 3rd trimester of pregnancy was 10.0%. Keywords: Gestational age, parity, pregnancy, third trimester, thrombocytopenia.

Case series of gestational thrombocytopenia

The antepartum diagnosis of maternal thrombocytopenia has become more common because platelet counts are now routinely obtained as a part of prenatal screening. We are reporting three cases of gestational thrombocytopenia, diagnosed clinically, admitted, evaluated and managed. Two cases reverted back to their normal status soon after delivery. Case one who presented as gestational thrombocytopenia was diagnosed as Immune thrombocytopenic purpura (ITP) and is on treatment and platelet monitoring even after delivery. Commonest platelet deficiency seen in obstetrics is Gestational thrombocytopenia which is 80%, but other underlying causes must be considered as well. A thorough history and physical examination rules out most causes. There is a positive correlation between thrombocytopenia with adverse fetomaternal outcome. Hence serial platelet monitoting should be done.