BACKGROUND: Thrombocytopenia at the time of delivery is considered as a risk factor for postpartum hemorrhage. However, platelet count thresholds for postpartum hemorrhage are variable and not extensively studied. OBJECTIVE: This study aimed to examine whether mild thrombocytopenia is associated with an increased risk of postpartum hemorrhage among women undergoing cesarean delivery. STUDY DESIGN: This was a retrospective cohort study of all women who underwent cesarean delivery at a tertiary care hospital labor and delivery unit from September 2015 to June 2018. Women with normal platelet counts (≥150,000/mL) were compared with women with mild thrombocytopenia (100,000−149,000/mL). Women were excluded if they had moderate to severe thrombocytopenia (platelet count of <100,000/mL) or had received a platelet transfusion. The primary outcome was postpartum hemorrhage (quantitative blood loss of ≥1000 mL). Secondary outcomes included frequencies of red blood cell transfusion, wound complications (surgical site infections, dehiscence, or hematoma), and postpartum emergency department visits. Adjusted odds ratios with 95% confidence intervals were calculated, controlling for maternal age, gestational age, body mass index, scheduled cesarean delivery, hypertension, and preoperative hemoglobin level. RESULTS: Of 3133 women, 2799 (89.3%) had normal platelet levels, 298 (9.5%) had mild thrombocytopenia, and 36 (1.2%) had moderate to severe thrombocytopenia. There were no differences in the risks of postpartum hemorrhage, need for a red blood cell transfusion, wound complications, or postpartum emergency department visit comparing women with normal platelet counts with those with mild thrombocytopenia (24.6% vs 25.8% [adjusted odds ratio, 1.16; 95% confidence interval, 0.88−1.54]; 6.5% vs 6.7% [adjusted odds ratio, 1.34; 95% confidence interval, 0.80−2.24]; 4.5% vs 5.4% [adjusted odds ratio, 1.53; 95% confidence interval, 0.88−2.64]; 9.0% vs 10.7% [adjusted odds ratio, 1.37; 95% confidence interval, 0.92−2.03], respectively). CONCLUSION: Preoperative mild thrombocytopenia was not associated with postpartum hemorrhage, red blood cell transfusion, wound complications, or postpartum emergency department visits in women undergoing cesarean delivery.

Summary With the increasing number of COVID-19 cases in the United States, more data is being reported on transmission, symptomatology, clinical course, and treatment of the virus. Research has focused on the trends and unique characteristics in at-risk populations, including pregnant women. This report summarizes the current data on considerations in pregnancy and postpartum period for mother and neonate to elucidate potential transmission risks for pediatric ophthalmologists.

PTB, labor duration at the extremes was not predictive of neonatal morbidity (ROC area 0.5713 spontaneous, 0.6441 induced). CONCLUSION: Preterm labor duration at the extremes of duration is an independent risk factor for maternal morbidity, however, it is not predictive. Induced preterm labor was more predictive of maternal morbidity than spontaneous.