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

Abstract

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.