Clinical Significance, Prevalence, and Natural History of Thrombocytopenia in Pregnancy-Induced Hypertension

Abstract

The purpose of this study was to establish the prevalence and clinical significance of thrombocytopenia in pregnancy-induced hypertension (PIH). Thrombocytopenia, defined as a platelet count less than 100,000/mm3 was found in 11.6% of all patients with PIH. Logistic regression analysis was used to assess the relative contribution of thrombocytopenia, proteinuria, and the degree of hypertension to maternal and perinatal outcome. Thrombocytopenia was the principal contributor to the occurrence of abdominal pain, liver dysfunction, the presence of schistocytes in the peripheral smear, proteinuria, fetal distress, and the requirement for blood transfusions. Thrombocytopenia was also associated with a higher incidence of preterm delivery and intrauterine growth retardation. The nadir platelet count occurred within 48 hours of delivery in 56.7% (21 of 37) of cases. The median number of days for recovery of the thrombocytopenia was 2.0 days (range, 0 to 8 days). In five patients thrombocytopenia preceded the clinical manifestations of PIH. We conclude that thrombocytopenia is an independent and important risk factor for the occurrence of maternal and perinatal complications in PIH.

Platelet count as a prognostic indicator in pregnancy induced hypertension

“…Thrombocytopenia complicating pregnancy is reported relatively frequently in severe pre eclampsia with occurrence ranging at 11 to 29%. 22,23 The incidence of thrombocytopenia associated with pregnancy induced hypertension in our study was 42.11%, which is much higher than earlier reported cases.…”

“…25 Romero et al reported that women with pre eclampsia and thrombocytopenia have higher incidence of maternal and neonatal complications. 22 The patients in our study are well defined group with diagnosed hypertensive disorder of pregnancy. All patients have been accurately randomized using the inclusion and exclusion criteria.…”

Maternal plasma concentrations of sST2 and angiogenic/anti-angiogenic factors in preeclampsia

“…The frequency of placental lesions [15,52,53], as is the frequency of multisystemic involvement [54][55][56][57], is higher in these patients than those who are diagnosed later. For example, hemolysis, elevated liver enzymes, low platelet (HELLP) syndrome is more common in patients with early-onset disease than in those diagnosed at term [58][59][60].…”

Preeclampsia: a link between trophoblast dysregulation and an antiangiogenic state

“…The presence of epigastric pain, thrombocytopenia, schistocytes, and elevated hepatic enzymes is characteristic of a severe form of preeclampsia, known as HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome (4)(5)(6)(7)(8)(9). Preeclampsia is a multisystemic disorder and a leading cause of maternal and perinatal morbidity/mortality (10).…”