Thrombocytopenia in pregnancy

Abstract

Thrombocytopenia during pregnancy is quite common. Evaluation of blood counts of pregnant women has shown that thrombocytopenia is the second most common haematological problem in pregnancy, after anaemia. While mostly thrombocytopenia has no consequences for either the mother or the foetus, in some cases it is associated with substantial maternal and/or neonatal morbidity and mortality. It may result from a number of diverse aetiologies. Adequate knowledge of these causes will help the clinicians in making proper diagnosis and management of thrombocytopenia in pregnancy. The evaluation of thrombocytopenia is essential to rule out any systemic disorders that may affect pregnancy management as thrombocytopenia can present as an isolated finding or in combination with underlying conditions. In this concise review, we have provided the overview of thrombocytopenia diagnosed during pregnancy.

Use of romiplostim in pregnancy for refractory idiopathic thrombocytopenic purpura: Two case reports with maternal and fetal outcomes and literature review

“…hypertensive disorders of pregnancy (15-20%), autoimmune processes (3-4%) or secondary to other conditions (1-2%), such as malignancy or infection. 1 ITP is rare in pregnancy, with an incidence of 1/1000 to 1/10,000 pregnancies. 1 Mechanisms behind the triggering or worsening of ITP in pregnancy are unknown, but current hypotheses include the dilutional effect of increased plasma volume and increased platelet turnover.…”

“…1 ITP is rare in pregnancy, with an incidence of 1/1000 to 1/10,000 pregnancies. 1 Mechanisms behind the triggering or worsening of ITP in pregnancy are unknown, but current hypotheses include the dilutional effect of increased plasma volume and increased platelet turnover. 1 Maternal thrombocytopenia increases the risk of spontaneous haemorrhage, especially at platelet counts of under 20 Â 10 9 /l.…”

“…1 Mechanisms behind the triggering or worsening of ITP in pregnancy are unknown, but current hypotheses include the dilutional effect of increased plasma volume and increased platelet turnover. 1 Maternal thrombocytopenia increases the risk of spontaneous haemorrhage, especially at platelet counts of under 20 Â 10 9 /l. Treatment targets in the third trimester include a platelet count of over 50 Â 10 9 /l to allow for safe vaginal or caesarean section delivery and over 80 Â 10 9 /l to allow for neuro-axial analgesia.…”

“…Of these, around 3% of neonates suffer from major bleeding and 1% have intraventricular haemorrhage. 1 However, predicting placental transfer of antiplatelet antibodies to individual neonates is difficult and the maternal platelet counts do not correlate with neonatal platelet counts. Treatment of ITP in pregnancy can be challenging.…”

Report on the management of thrombocytopenia in obstetric patients: A retrospective study

“…Palta and Dhiman [ 25 ] have suggested that the investigation of thrombocytopenia is principal to rule out any systemic disorders that may affect pregnancy management as thrombocytopenia can be available as an isolated finding or in combination with underlying situations.…”