Pregnancy emerged thrombocytopenia: maternal and fetal outcome

Abstract

Background: A low platelet count is often an incidental finding in pregnancy. It can be an indicator of a severe systemic disorder requiring emergent maternal and fetal care or can just be unique to pregnancy with no harm to mother or fetus. Physiological decrease in platelet count is seen in pregnancy due to hemodilution and hypercoagulating state, though the exact pathophysiology is still unclear.Methods: It is a prospective observational study done in a tertiary care centre.Results: In about 11,258 cases screened 46 patients had thrombocytopenia (0.4%). The commonest etiology is found to be gestational thrombocytopenia (n=21, 45.6%) followed by preeclampsia/ eclampsia/ HELLP (haemolysis, elevated liver enzymes, low platelet count) syndrome (n=19, 41.3%). Only one patient had immune thrombocytopenic purpura (ITP) and 7 (15.3%) were associated with amplified fragment length polymorphism (AFLP). Maximum of them (n=19, 41.3%) underwent spontaneous vaginal delivery. 4 patients (8.6%) had postpartum haemorrhage, 6 (13.04%) had ceserean section wound infection, 4 (8.6%) had disseminated intravascular coagulation (DIC) and 4 (8.6%) had multiorgan failure. 13 patients (28.3%) had platelet count between 40 to 60 thousand per cumm, 11 (23.9%) had between 60 to 80 thousand per cumm, 10 (21.7%) had between 80,000 to 1 lakh and none had their platelet count less than 20,000 per cumm.Conclusions: Gestational thrombocytopenia is not a preventable condition. It is an incidental finding in pregnancy. With strict vigilance during intrapartum and postpartum period, even without any treatment proper for the same, the maternal and fetal outcome is found to be good.

Prevalence of Thrombocytopenia and Platelet Dysfunction in Women Delivering at a Tertiary Care Hospital and Prevalence of Platelet Abnormalities in their Neonates with Perinatal Outcomes: A Retrospective Study

“…It was found to be the most common aetiology in all other cases. However, our findings were lower than other studies, as Nisha et al [17] reported 64.21% While 22.6% of our study group had ITP, Tasneem et al [19] had only 1 case of ITP.…”

Maternal and fetal outcome among pregnant women presenting with thrombocytopenia

“…DIC in 2% patients, DIC with acute renal failure in 2% patients, Only Renal failure in 1%, Wound sepsis in 1%. In our study, incidence of PPH was higher as compared to studies reported by Tasneem et al [15] (8.6%), Sumathy et al [16] (7.1%) and Chauhan M et al [7] (6.73%. because of obstretic causes (like prolonged labor, obstructed labor, abruption).…”