Maternal and fetal outcome among pregnant women presenting with thrombocytopenia

Abstract

Background: Thrombocytopenia is defined as platelet count less than 150000/μL.1,2 It is second only to anemia as the most common haematological abnormality encountered during pregnancy. Thrombocytopenia is encountered in 7-8% of all pregnancies but when patient's obstetric and medical condition are excluded, incidence down to 5.1%. Methods: This prospective observational study was conducted in the department of Obs & Gynae at Government Medical College & J. K. Lon hospital, Kota over a period of 1 year. Out of 2897 women, 1500 women willing to participate in the study and fulfilled our inclusion criteria. Out of 1500 women screened,100 women were found to have thrombocytopenia. Results: Prevalence of thrombocytopenia was 6.67%. The distribution of thrombocytopenia with etiology is 56% with gestational thrombocytopenia,35% including pre-eclampsia, HELLP syndrome, eclampsia, gestational hypertension and superimposed pre-eclampsia and 9% including DIC, ITP, Dengue and Malaria and hypersplenism. Mean gestational age was 38.42±1.69 weeks.53% women delivered vaginally and 47% had delivered by LSCS. 42% patients needed blood and blood products transfusion and 58% patients no blood transfusion. Newborn 76.47% (78) had normal birth weight and 23.53% (24) had low birth weight with mean birth weight 2.58±0.49kg.33(31.35%) neonates required NICU admission and 68.65% (69) newborns were healthy. Out of 102 neonates, 94.12% (96) had normal platelet count and 5.88%(6) had thrombocytopenia. Neonatal mortality3.92% (4) neonates. Conclusions: Most common cause of thrombocytopenia during pregnancy was gestational thrombocytopenia but other underlying causes must be considered as well. A careful examination and simple laboratory test are needed so that a serious condition that may require specific and urgent management (examples HELLP syndrome, severe pre-eclampsia, TTP, HUS, AFLP) is not missed. Management of pregnant women with platelet disorders requires a multidisciplinary approach.