Diagnosis and management of maternal thrombocytopenia in pregnancy

Abstract

SummaryThrombocytopenia is a common finding in pregnancy, occurring in approximately 7-10% of pregnancies. It may be a diagnostic and management problem, and has many causes, some of which are specific to pregnancy. Although most cases of thrombocytopenia in pregnancy are mild, and have no adverse outcome for either mother or baby, occasionally a low platelet count may be part of a more complex disorder with significant morbidity and may be life-threatening. Overall, about 75% of cases are due to gestational thrombocytopenia, 15-20% secondary to hypertensive disorders; 3-4% due to an immune process, and the remaining 1-2% made up of rare constitutional thrombocytopenias, infections and malignancies. In this review, a diagnostic approach to investigating thrombocytopenia in pregnancy is presented, together with antenatal, anaesthetic and peri-natal management issues for mother and baby, followed by a detailed discussion on the specific causes of thrombocytopenia and the management options in each case.

Prevalence of thrombocytopenia in Parturient: Experience in Tertiary Care Center

“…Many reports observed higher rates of preterm deliveries in patients with moderate to severe thrombocytopenia. 4,[6][7][8]11 Our study also had a similar finding.…”

“…7 In our study higher rate of IOL (induction of labor) in women with hypertensive disorder (23%), mainly in HELLP syndrome was noted because the definitive treatment is to deliver. 49% women had caesarean section in this study.…”

“…Several studies reported similar incidence. [6][7][8] Presence of medical and obstetric risk factors did not have any influence on maternal and neonatal outcome in these patients. This finding is similar to Nisha et al study.…”

“…These observations are similar to previously published studies. 6,7,11,14 Perinatal outcomes are compared with other studies as shown in table 6.…”

Thrombocytopenia in pregnancy in a tertiary care hospital: a retrospective study

“…Where the maternal platelet count remains low (<50,000/μL) around the time of delivery, platelets should be available on standby, but are likely to be destroyed quickly after transfusion due to immune process, so platelets administration should be timed judiciously and should be given in well-established rather than early labor, if there are increased bleeding complications. 9 The challenge to the clinician is to weigh the risks of maternal and fetal bleeding complications against the benefits of diagnostic tests and interventions.…”