Prospective Study of Thrombocytopenia in Pregnancy and Its Effect on Maternal and Foetal Outcome

Abstract

BACKGROUNDThrombocytopenia is the second most common haematological finding in pregnancy after anaemia. The aim of the study is to study the various aetiological factors associated with thrombocytopenia and its management in pregnancy. MATERIALS AND METHODSIt is a prospective study carried out in 160 cases, which were identified to have moderate-to-severe thrombocytopenia during over a period of 2 years. History taken regarding preeclampsia, ITP, drug usage, viral infection, thrombocytopenia in previous pregnancy. General, systemic and obstetric examination were done. RESULTSThe highest incidence of thrombocytopenia was found in the age group of 21-25 years, i.e. 83 cases (51.8%). Out of total 160 cases, 90 (56.25%) cases are multigravida while 61 (38.1%) are primigravida. Out of total 160 cases, 128 i.e. 80% are unbooked while 32 i.e. 20% are booked. Of 68 cases delivered by LSCS, spinal anaesthesia was given in 45 cases, i.e. 66.1% general anaesthesia in 22 cases (32.3%), epidural was given in 1 case (1.47%). Gestational thrombocytopenia has highest aetiology of 21.25%, i.e. 34 cases. Severe preeclampsia were 30 cases (18.75%). Dengue, SLE and chronic liver disease are least with incidence of 1.25%, i.e. 2 cases each. Partial HELLP are 25 cases (15.6%) and HELLP are 24 cases (15%). Severe preeclampsia with abruption 21 cases (13.1%). DIC are 9 (5.6%). Pancytopenia are 4 (2.5%). Platelet transfusions were required in 69 patients out of 160, i.e. in 43.1% of cases. All the cases of IUGR belonged to preeclampsia and associated disorders group. 26 out of 109 cases of preeclampsia were associated with IUGR. In preeclampsia and associated disorders group, 49 out of 109 cases were IUD, stillborn, nonviable. Chi-square test, p value is 0.0001, which is highly statistically significant, implying there is an association between IUD, stillborn and thrombocytopenia due to severe preeclampsia group when compared to other group including ITP, gestational thrombocytopenia and SLE, dengue, pancytopenia. Chi-square test p value is 0.0001, which is highly statistically significant, implying there is an association between IUD, stillborn and thrombocytopenia due to severe preeclampsia group when compared to other group including ITP, Gestational thrombocytopenia and SLE, Dengue, Pancytopenia. CONCLUSIONCareful surveillance is required in these high-risk patients in order to ensure early detection and treatment of the complications so as to decrease the foetomaternal morbidities.