Characterization of Thrombocytopenia in Pregnant Women at a Tertiary Care Center: A Preliminary Study of 121 Patients

Abstract

Background: Partum-related hemorrhage is a major cause of maternal morbidity and mortality, the risk of which increases in women with thrombocytopenia. An accurate etiological diagnosis of thrombocytopenia in pregnancy is essential for optimal therapeutic management to prevent maternal and fetal morbidity and mortality. Our study aims to establish various prevalent causes of thrombocytopenia in pregnancy and its demographic characteristics. Materials and methods: In total, 121 pregnant patients visiting the Antenatal Outpatient Department and/or Emergency Department at a tertiary medical center with thrombocytopenia (platelet counts <1,50,000/µL) were recruited for the study. Detailed blood investigations were done to establish the accurate etiology of thrombocytopenia. Special attention was given to differentiating between pregnancy-associated causes and those incidental to pregnancy. Results: Gestational thrombocytopenia (GT) accounted for 56.2% of the total cases, and hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome accounted for 13.2% of the cases, closely followed by idiopathic thrombocytopenic purpura (12.4%). Thrombocytopenia associated with nutritional deficiencies was seen in 5.8% of the cases. Other less common causes included fever-associated thrombocytopenia (2.5%), disseminated intravascular coagulation (DIC) (2.5%), acute fatty liver of pregnancy (AFLP) (0.8%), atypical hemolytic uremic syndrome (HUS) (0.8%), and antiphospholipid antibody (APLA) syndrome (0.8%). Conclusion: Gestational thrombocytopenia (GT) is the commonest cause of thrombocytopenia during pregnancy.