Risk factors and fetomaternal outcome in pregnancy with thrombocytopenia.

Abstract

Objectives: To find out the risk factors and their effects on mother and fetus in pregnancy with thrombocytopenia. Study Design: Cross sectional study. Setting: Department of Obstetrics and Gynaecology at Liaquat University Hospital Hyderabad. Period: Six months (1st July 2016 to 31st December 2016). Material and Methods: Total 96 patients with gestational age >24 weeks having platelet count below 150X109/L were included in the study. Patients admitted throughout patient clinic department of obstetrics & Gynecology at Liaqat University Hospital. Those patients having platelet count below 150X109/L were registered for study. Proforma filled which include Patients demographics details, gestational age, complete blood count (Having platelet count) other important investigations like coagulation profile (PT, APTT), Ultrasound and LFT noted in proforma SPSS version used for analysis. Descriptive statics were calculated frequency and percentages were drawn for the study. Results: Risk factors related to thrombocytopenia included PIH18 (18.8%), preeclampsia 14(14.6%), eclampsia 10(10.3%), HELLP Syndrome 6(6.3%), Viral Hepatitis 12(12.5%) and in 36(37.5%) no risk factors was found. Maternal complication were placental abruption21 (21.8%) post partam hemorrhage 14(14.6%). 7(7.3%) were transferred to ICU and 02(2.1%) maternal death was seen. Fetal outcome include low Apgar score of <6 in 17(17.7%), low birth weight 16(16.7%) and NICU admission 11(11.5%). Conclusion: Thrombocytopenia is a common finding in pregnancy careful diagnosis is important to distinguish serious causes from mild then to manage mother and fetus appropriately. Thrombocytopenia in pregnancy is associated with adverse maternal and fetal outcome in significant number of pregnant woman.

Feto-Maternal Outcome in Pregnancy With Thrombocytopenia and Abnormal Platelet Indices

“…In our study, around 21.33% (n=150) of women had preeclampsia, followed by hypertension and anemia (10.0% each, n=150) which was comparable to the study by Padmawar et al [ 2 ]. This is in contrast to the work of Qureshi et al in which preeclampsia was observed in 14.6% (n=86) cases [ 3 ]. The variation may be due to differences in timing of presentation on which the diagnosis is largely dependent, besides severity of thrombocytopenia and the association with other abnormalities.…”

“…Platelet indices are of significant discriminative value in differentiating the various causes of thrombocytopenia [ 11 ]. Qureshi et al showed placental abruption in 21.8% (n=86), postpartum hemorrhage in 14.6% (n=86) and maternal mortality in 2.1% (n=86) of these women [ 3 ]. Chauhan et al [ 12 ] reported that pregnancy-induced hypertension (PIH) was associated with 26.2% (n=65) of thrombocytopenic women.…”

“…According to one study [ 2 ], gestational thrombocytopenia is the commonest cause of thrombocytopenia in pregnancy with an incidence of 70% (n=100 study participants with thrombocytopenia), followed by preeclampsia (22%), hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome (4%), idiopathic thrombocytopenic purpura (ITP) (2%) and dengue (2%). In another study (where n=96 cases with thrombocytopenia) the maternal complications were placental abruption (21 cases, 21.8%), postpartum hemorrhage (14 cases, 14.6%), seven cases (7.3%) of the women were transferred to ICU and in two cases (2.1%) maternal death was seen [ 3 ]. The present study was aimed at evaluation of the feto-maternal outcome of thrombocytopenia in pregnancy and correlation of the same.…”