Background: Thrombocytopenia in pregnancy occurs due to several etiologies which include both pregnancy specific and non pregnancy related causes. It is second only to anemia as the most common hematological abnormality encountered in pregnancy. Better antenatal care has led to increased detection. Once diagnosed, it is important to further evaluate and to determine the cause to optimize management. Several studies have been undertaken across the world; however there are very few studies in Kerala hence this study. The aim of this study was to determine the risk factors of thrombocytopenia in pregnancy.Methods: This was a case control study undertaken in the Department of Obstetrics and Gynecology, Medical college Hospital, Trivandrum, Kerala. Using purposive sampling, a sample size of 96 cases and 96 controls were included in this study. “Cases” were antenatal women with thrombocytopenia and “controls” were consecutive women without it. Study period was 18 months and analysis was done using SPSS version 22.Results: In 49% of subjects ,the cause was identified as gestational thrombocytopenia,39.5% cases were due to hypertensive disorders of pregnancy.10.4% was due to ITP. SLE, AFLP, Dengue infection, HUS and APLA were rare causes of thrombocytopenia in our hospital. Of the 96 cases enrolled in the study,88 were diagnosed during pregnancy. Amongst the hypertensive disorders,16.7% was due to gestational hypertension,10.4% due to preeclampsia and 7.4% were due to HELLP syndrome.82.3% of patients with thrombocytopenia in this study were asymptomatic.Conclusions: Thrombocytopenia should be evaluated by making a practice of routinely checking the platelet count and peripheral smear in early pregnancy and also in third trimester to enable early diagnosis since most cases may be asymptomatic.

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Maternal anemia is associated with poor intrauterine growth, pre maturity and increased risk of preterm births and low birth weight rates, this leads to increase perinatal mortality and morbidity causing poor growth in infants, childhood and adolescence, and ultimately leads to adult low weight and height which in turn is a determinant for birth weight and intrauterine growth. Patients fulfilling inclusion criteria were included in the study after obtaining informed consent. Then they were categorized into moderate and severe anemia depending on their hemoglobin level. All hemoglobin level was estimated by Sahli's method. Moderate anemia was defined as hemoglobin in between 7-10gm% and severe anemia if hemoglobin <7gm%. The MCA PSV was within 50-95 th centile for gestational age in 92.9% for group 2,and 42.9% for group 1.while 57.1% group 1 and only 7.1% of group 2 cases were having MCA PSV values in between 5-50 th centile for each gestational age. Mean CPR in group 1 was 2.05+/-0.45 and in group 2 was 2.02+/-0.39, the difference of which was not statistically significant.

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