A study on association of thrombocytopenia with pregnancy induced hypertension

Kasturi V. Donimath; Annapurna M. Sambrani; Pratik M. Rathod

doi:10.18203/2320-1770.ijrcog20160589

Authors

Kasturi V. Donimath Department of Obstetrics & Gynaecology, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India
Annapurna M. Sambrani Department of Obstetrics & Gynaecology, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India
Pratik M. Rathod Department of Obstetrics & Gynaecology, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20160589

Keywords:

PIH, Pre-eclampsia, Thrombocytopenia, Mortality, Morbidity, Economical, Reliable, Fetal/Maternal outcome, IUD, IUGR, DIC, HELLP

Abstract

Background: Hypertension is common complication of pregnancy and contributes significantly to maternal and perinatal morbidity and mortality. With incidence of 5-7% of all pregnancy. Platelet count is the most simple and economical method of prediction of PIH, way before the derangements in PT, PTT and TT occur. This study sought the importance of platelet count as the most consistent and reliable method in predicting the severity of PIH. The aim and objectives of the study was to correlate severity of PIH with degree of thrombocytopenia and the degree of thrombocytopenia with fetal and maternal outcome.

Methods: Prospective observational study was done during November 2014 to June 2015. A total of 100 cases were included in this period that was diagnosed as PIH. Investigations like platelet count, LFT, RFT, PT were done. Observations were tabulated, analyzed and conclusions were drawn.

Results: 66% of all the cases had severe preeclampsia and 56% had thrombocytopenia. There was very high significant relationship between the degree of thrombocytopenia with the severity of the PIH (at p <0.001). 12% of the fetuses had IUD, 10% had IUGR, 4% died after birth and 2% had severe birth asphyxia. 5 % of the mothers had DIC, 3 % showing HELLP syndrome, and 1% died.

Conclusions: Thrombocytopenia is the most common complications of PIH and at times is life threatening. Therefore, platelet count can be used as an early, simple, and rapid test to assess the severity of pre eclampsia and prevent progression to HELLP syndrome and DIC.

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References

Sivakumar S, Bhat BV, Badhe BA. Effect of pregnancy induced hypertension on mothers and their babies. Indian J Pediatr. 2007;74:623-5.

Anand S, Kirshnanand. Perinatal outcome in growth retarded babies born to normotensive and hypertensive mothers: A prospective study. People’s J Sci Res. 2012;5:24-8.

Sibai BM. Hypertension in pregnancy. Clinical Obstet Gynecol. 1999:421-36.

Marshall D. Lindheimer, Sandra J. Taler, and F. Gary Cunningham. Hypertension in pregnancy. Journal of the American Society of Hypertension. 2008;2:484-94.

Menzies J, Magee LA, MacNab YC, Ansermino JM, Li J, Douglas MJ, et al. Current CHS and NHBPEP criteria for severe preeclampsia do not uniformly predict adverse maternal or perinatal outcomes. Hypertens Pregnancy. 2007;26:447-62.

Gibson G, Hunter D, Neame PB, Kelton JG. Thrombocytopenia in pre-eclampsia and eclampsia. Semin Thromb Hemost. 1982;8:234-47.

Burrows RF, Hunter DJS, Andrew M, Kelton JG. A prospective study investigating the mechanism of thrombocytopenia in preeclampsia. Obstet Gynecol. 1987;70:334-8.

Heilmann L, Rath W, Pollow K:H hemostatic abnormalities in patients with severe preeclampsia. Clin appl thromb hemost. 2007;13:285.

Leduc L, Wheeler JM, Kirshon B, et al: Coagulation profile in sever preeclampsia. Obstet gynecol. 1992;79:14.

Meshram DP, Chavan YH, Kadam PN, Panchal MG, Ramteke DJ. Maternal and foetal outcomes in pregnancy induced hypertension - A hospital based study. Int J Pharm Sci Invention. 2014;3:23-6.

Andrews L, Haridas N, Vaishnav S, Desai K. Biochemical and hematological investigations in pregnancy induced hypertension. J Cell Tissue Res. 2012;12:3009-13.

Vigil D, Gracia U. Pregnancy complicated by pre-eclampsia]eclampsia with HELLP syndrome P. International International Journal of Gynecology & Obstetrics. 2001;72:17-23.

Langer A, Villar J, Tell K, Kim T, Kennedy S. Reducing eclampsia-related deaths—a call to action. Lancet. 2008;371:705–6.

McCrae KR, Samuels P, Schreiber AD. Pregnancy-associated thrombocytopenia: pathogenesis and, management. Blood. 1992;80:2697-714.

Dame C. Thrombopoietin in thrombocytopenias of childhood. Sem Thromb Haemost. 2001;27:215-2.

Roberts IA, Murray NA. Neonatal thrombocytopenia: new insights into pathogenesis and implications for fetal management. Curr Topics Micro Immunol. 2001;13:16-23.

Prakash J, Pandey LK, Singh AK, Kar B. Hypertension in pregnancy: Hospital based study. J Assoc Physicians India. 2006;54:273-8.

Sandhya S, Vishnu BB, Bhawana AB. Effect of pregnancy induced hypertension on mothers and their babies. Indian J Pediatr. 2007;74:623-5.

Annam V, Srinivas K, Yatnatti SK, Suresh DR. Evaluation of platelet indices and platelet counts and their significance in preeclampsia and eclampsia. Int J Biol Med Res. 2011;2:425-8.