Thrombocytopenia during pregnancy: an institutional based prospective study of one year

Pandey, Abha; Singh, Roma

doi:10.18203/2320-6012.ijrms20173550

Cited by 5 publications

(4 citation statements)

References 7 publications

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“…Pregnancy triggers various biological mechanisms that affect hematopoietic and related systems [1]. Thrombocytopenia is the second most common hematologic disorder after anemia [2]. The incidence of thrombocytopenia during pregnancy has been shown to be between 6 and 10 % and is defined as a platelet count < 150 × 10 3 /µl [3].…”

Section: Introductionmentioning

confidence: 99%

5 Yearsʼ Experience of a Tertiary Center with Thrombocytopenic Pregnancies: Gestational Thrombocytopenia, Idiopathic Thrombocytopenic Purpura and Hypertensive Disorders of Pregnancy

Fadıloğlu

Ünal

Portakal

et al. 2019

Geburtshilfe Frauenheilkd

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Aim To evaluate thrombocytopenic pregnancies including gestational thrombocytopenia (GT), idiopathic thrombocytopenic purpura (ITP), and hypertensive disorders of pregnancy (HDP). Materials and Methods We evaluated the pregnancy outcomes and laboratory findings of 385 patients diagnosed with GT, ITP, or HDP whose thrombocyte levels were < 150 000/µL. Results GT, ITP, and HDP were the final diagnoses in 315 (81.8%), 35 (9.1%), and 35 (9.1%) cases, respectively. Patients diagnosed during the 1st trimester and diagnosed with ITP had significantly lower minimal platelet counts during the antenatal period and prior to delivery (p < 0.001; p < 0.001; p < 0.001; p < 0.001). Transfusion of any kind of blood product was given in 9.9% (n = 38) of all cases. Twelve patients had methylprednisolone and/or intravenous immunoglobulin treatments during the antenatal period. All patients who had undergone medical treatment were also found to have ITP. Four out of 385 patients underwent hysterectomy post partum due to refractory hemorrhage. Analysis of newborn platelet levels showed no statistical differences between any of the groups. Despite the lack of statistical significance, the rate of thrombocytopenia in newborns was 50% in patients with severe thrombocytopenia, while rates were 25.6 and 18.1% in patients with moderate and mild thrombocytopenia, respectively. Conclusion Thrombocytopenic pregnancies must be carefully evaluated with regard to the severity of thrombocytopenia, gestational period at initial diagnosis, and etiology. In particular, patients with ITP must be evaluated carefully as these patients are more likely to require transfusions and have platelet counts < 50 × 103/µl.

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Section: Introductionmentioning

confidence: 99%

5 Yearsʼ Experience of a Tertiary Center with Thrombocytopenic Pregnancies: Gestational Thrombocytopenia, Idiopathic Thrombocytopenic Purpura and Hypertensive Disorders of Pregnancy

Fadıloğlu

Ünal

Portakal

et al. 2019

Geburtshilfe Frauenheilkd

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“…In the present study, severe thrombocytopenia was seen in 6.73% of pregnant women which is almost similar to the study conducted by Singh et al [17] (7.4%), Vishwekar et al [18] (6.4%) and Zutshi et al [16] (7%). Severe thrombocytopenia was seen in higher percentage of pregnant women (20%) in the study by Pandey et al [19] However, Chauhan et al [11] observed a very low (1.5%) incidence of severe thrombocytopenia the reason of which was not explained by them. [17] 74.7% 17.9% 7.4% Vishwekar et al [18] 78.4% 15.2% 6.4% Chauhan et al [11] 63.1% 35.4% 1.5% Zutshi et al [16] 62% 31% 7% Pandey et al [19] 22% In our study, gestational thrombocytopenia (69.23%) was the commonest etiology which was similar to the study conducted by Vishwekar et al [18] (68.46%) and Chauhan et al [11] (68.2%).…”

Section: Discussionmentioning

confidence: 90%

“…Severe thrombocytopenia was seen in higher percentage of pregnant women (20%) in the study by Pandey et al [19] However, Chauhan et al [11] observed a very low (1.5%) incidence of severe thrombocytopenia the reason of which was not explained by them. [17] 74.7% 17.9% 7.4% Vishwekar et al [18] 78.4% 15.2% 6.4% Chauhan et al [11] 63.1% 35.4% 1.5% Zutshi et al [16] 62% 31% 7% Pandey et al [19] 22% In our study, gestational thrombocytopenia (69.23%) was the commonest etiology which was similar to the study conducted by Vishwekar et al [18] (68.46%) and Chauhan et al [11] (68.2%). The incidence of thrombocytopenia in neonates born to gestational thrombocytopenic women is similar to those reported ~ 131 ~ in non gestational thrombocytopenia women [20] .…”

Section: Discussionmentioning

confidence: 90%

A prospective study to evaluate the role of maternal thrombocytopenia on maternal and fetal outcome

Chauhan¹,

Chaudhary²,

Mehta³

et al. 2021

Int. J. Clin. Obstet. Gynaecol.

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Introduction: Thrombocytopenia is a very common finding in pregnancy, occurring in approximately 10% of women and it is the second most common hematological abnormality during pregnancy. Aims and Objective: To study the cases of thrombocytopenia during pregnancy, its cause and effect on feto-maternal outcome. Material and Methods: Prospective observational study included 1000 women (>30 weeks of gestation) out of which 104 women were found to had thrombocytopenia and 896 women had normal platelet count. Results: Mean age among thrombocytopenic women was 23.89±3.31 years and in without thrombocytopenia, it was 24.34±3.79 years. 39(37.5%) women with thrombocytopenia and 471(52.56%) women without thrombocytopenia were nulliparous, 65(62.5%) women with thrombocytopenia and 425(47.44%) women without thrombocytopenia were multiparous. Mean gestational age was 37.05±2.26 weeks observed in women with thrombocytopenia and in women without thrombocytopenia, it was 37.46±2.35 weeks. Mean platelet counts of pregnant women with thrombocytopenia was 98028.84±25679.67/µL and in pregnant women without thrombocytopenia, it was 243198.66±49245.80/µL. A total of 56(53.85%) women had mild thrombocytopenia, 41(39.42%) had moderate and 7(6.73%) women had severe thrombocytopenia. Most common diagnosis observed was gestational thrombocytopenia i.e. 72(69.23%) cases followed by preeclampsia (16.34%). Vaginal delivery found to be most common i.e. 72(69.23%) followed by 32(30.77%) cases of cesarean delivery. Fetal distress was the most common indication of cesarean section i.e. 18 (17.30%) cases. Mean birth weight was 2.84±0.62kgs. Apgar score of 7/9 observed in 96(92.30%) neonates. Out of 104 babies, 4(3.84%) intrauterine death were occurred and 18(17.30%) babies were premature. Mean hospital stay of the women was 5.01±4.25 days. In mild category, mean hospital stay was 4.75±3.89 days, in moderate it was 5±4.18 days and in severe in severe, it was 6.71±0.677 days (p >0.05). Conclusion:Present study concluded that early interdisciplinary evaluation of thrombocytopenia in pregnancy is required for optimal care of mother and the neonate as risk varies greatly depending on cause of thrombocytopenia. Accurate etiological diagnosis is essential for optimal therapeutic management and timely monitoring of platelet count is mandatory.

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“…9 According to Sibai, the rate of cesarean section with HELLP syndrome is significant, especially when the pregnancy is shorter than 34 weeks. 10 The cesarean section rate in pregnancies fewer than 30 weeks is 87.0%. 11 Maternal complications due to bleeding tendencies like placental abruption, postpartum haemorrhage were not evident in the study population, only 2 cases of DIC and 6 cases of ICU admission noted as maternal complication.…”

Section: Discussionmentioning

confidence: 99%

Feto-maternal outcome of pregnancy with thrombocytopenia

Kharadi,

Shah,

Deliwala

et al. 2024

Int J Reprod Contracept Obstet Gynecol

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Background: Thrombocytopenia is the second most haematological abnormality in pregnancy where the platelets count below 1,50,000/µl. Gestational thrombocytopenia is most common cause of thrombocytopenia, accounts for 70% of thrombocytopenia in pregnancy. Methods: It is retrospective study with 30 antenatal women at any gestational age having thrombocytopenia, platelet count less than 1,50,000/µl at SVP Hospital, Ahmedabad during duration of May 2023-November 2023. All the pregnant women who attend OPD and admitted in SVP Hospital, Ahmedabad were included in the study. Results: The present study found that gestational thrombocytopenia (53.34%) accounted for most common cause of thrombocytopenia, followed by hypertensive disorders (10.0%), HELLP syndrome (6.67%), dengue and malaria (6.67%), DIC (6.67%) and ITP (3.34%) in which 53.34% women has mild, 36.67% has moderate and 10% has severe thrombocytopenia. In this study vaginal delivery accounts for 33.34% and caesarean delivery accounts for 66.67%. In present study 50.0% patient of gestational thrombocytopenia didn’t required any treatment. About 6.67% patients required transfusion of PRC and 33.34% of neonates needed NICU admission. Neonatal mortality due to complications like prematurity, septicemia was seen in 10.0% of the cases. Conclusions: Outcome of pregnancy with moderate to severe thrombocytopenia depends mainly on the etiology of thrombocytopenia. Early interdisciplinary evaluation of thrombocytopenia during pregnancy can help in optimizing care as fetal outcomes and management depend on the etiology.

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Thrombocytopenia during pregnancy: an institutional based prospective study of one year

Cited by 5 publications

References 7 publications

5 Yearsʼ Experience of a Tertiary Center with Thrombocytopenic Pregnancies: Gestational Thrombocytopenia, Idiopathic Thrombocytopenic Purpura and Hypertensive Disorders of Pregnancy

5 Yearsʼ Experience of a Tertiary Center with Thrombocytopenic Pregnancies: Gestational Thrombocytopenia, Idiopathic Thrombocytopenic Purpura and Hypertensive Disorders of Pregnancy

A prospective study to evaluate the role of maternal thrombocytopenia on maternal and fetal outcome

Feto-maternal outcome of pregnancy with thrombocytopenia

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