Fetomaternal outcome of thrombocytopenia in pregnancy

Abstract

Background: Thrombocytopenia in pregnancy can result from multiple etiologies, some specific to pregnancy and others in non-pregnant settings. Platelet count below 1.5 lakh/cumm is called thrombocytopenia. It is the second most common haematological disorder in pregnancy. It affects nearly 6 to 15% of all pregnancies. To determine the causative factors of thrombocytopenia in pregnancy and to study maternal and fetal outcome of thrombocytopenia in pregnancy.

Method: This prospective observational study was conducted on 87 patients with platelet counts below the thrombocytopenic range at the tertiary care centre, ESIC MC AND PGIMSR Medical College and Hospital, from October 2023 to October 2024 and informed consent was obtained from all patients.

Results: Gestational thrombocytopenia is the most common cause of thrombocytopenia during pregnancy (50.5%) hypertensive disorder of pregnancy (20%) and intrahepatic cholestasis of pregnancy (8%). Most of the women were primigravida (37.9%) with term pregnancies (78%) and less than 30 years old (66.6%) with high incidence of mild thrombocytopenia (72.4%). Approximately, 5.7% patients required steroid therapy. In this study, the incidence of intrauterine death is 5.7%, neonatal mortality is 1.1% fetal growth restriction (20.6%) and neonatal thrombocytopenia is 4.5%.

Conclusion: Careful blood pressure monitoring and a complete hemogram would suffice for the early detection of the disease. Proper antenatal care and institutional deliveries enable obstetricians to diagnose thrombocytopenia and its complications at an early stage. Careful surveillance is required for these women in high-risk units for early detection and treatment to reduce adverse maternal and neonatal outcomes. Platelet count to be monitored periodically.