Published: 2020-03-25

Study of thrombocytopenia in pregnancy: clinical presentation and outcome at tertiary care rural institute

Jigyasa Singh, Kalpana Kumari, Vandana Verma


Background: Platelet count below 1.5 lakh/cumm is called as thrombocytopenia. After anaemia it is the second most common haematological disorder in pregnancy. It affects nearly 6 to 15%; on an average 10% of all pregnancies. Gestational thrombocytopenia is a clinically benign thrombocytopenic disorder usually occurring in late pregnancy. It resolves spontaneously after delivery.

Methods: It is a hospital based prospective observational study over a period of 1 year. All pregnant women who attended OPD at the department of obstetrics and gynecology, UPUMS, Saifai for antenatal checkup were included for the study and blood sample was withdrawn.

Results: Out of 263 cases enrolled for study, 90 women were found to have thrombocytopenia, and 173 had normal platelet count. Thus, incidence of thrombocytopenia was 34%. Gestational thrombocytopenia accounted for majority of cases of thrombocytopenia in pregnancy (50%) followed by hypertensive disorders (22.4%). It was further followed by ITP (11.11%) and dengue (5.5%).

Conclusions: Gestational thrombocytopenia is the most common cause of thrombocytopenia during pregnancy (50%), but other underlying causes must be considered as well. A thorough history and physical examination will rule out most causes.


Gestational thrombocytopenia, Hemolysis elevated liver enzymes and low platelets, Massive hemorrhage, Puerperal sepsis, Renal failure, Thrombocytopenia in pregnancy

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Shehata N, Burrows RF, Kelton JG. Gestational Thrombocytopenia. Clin Obstet Gynecol. 1999;42:327-34.

Burrows RF, Kelton JG. Thrombocytopenia at delivery: a prospective survey of 6715 deliveries. Am J Obstet Gynecol. 1990;162(3):731-4.

Kadir RA, McLintock C. Thrombocytopenia and disorders of platelet function in pregnancy. Semin Thromb Hemost. 2011;37(6):640-52.

Khellaf M, Loustau V, Bierling P, Michel M, Godeau B. Thrombocytopenia and pregnancy. Rev Med Interne. 2012;33(8):446-52.

Karim R, Sacher RA. Thrombocytopenia in pregnancy. Curr Hematol Rep. 2004;3(2):128-33.

Sainio S, Kekomaki R, Rikonen S, Teramo K. Maternal thrombocytopenia at term: a population-based study. Acta Obstet Gynaecol Scand. 2000;79(9):744-9.

Singh N, Dhakad A, Singh U, Tripathi, Sankhwar P. Prevalence and characterization of thrombocytopenia in pregnancy in Indian Women. Indian J Hematol Blood Transfus. 2012;28:77-81.

Wei J, Liu GL, Liang MY, Wang SM. Effect of general anesthesia used in cesarean section on maternal-neonatal outcome of pregnancy complicated with severe thrombocytopenia. Zhonghua Fu Chan KeZaZhi. 2009;44(9):665-8.

Boehlen F, Hohlfeld P, Extermann P, Perneger TV, de Moerloose P. Platelet count at term pregnancy: a reappraisal of the threshold. Obstet Gynecol. 2000;95(1):29-33.

Boehlen F. Thrombocytopenia during pregnancy. importance, diagnosis and management. Hemostaseol. 2006;26:72-4.

Kamphuis MM, Oepkes D. Fetal and neonatal alloimmunre thrombocytopenia: prenatal interventions. Prenat Diagn. 2011;31(7):712-9.

Samuels P, Bussel JB, Braitman LE. Estimation of the risk of thrombocytopenia in the offspring of pregnant women with presumed immune thrombocytopenic purpura. N Engl J Med. 1990;323(4):229-35.

Burrows RF, Kelton JG. Fetal thrombocytopenia and its relation to maternal thrombocytopenia. N Engl J Med. 1993;329(20):1463-6.

Cook RL, Miller RC, Katz VL, Cefalo RC. Immune thrombocytopenic purpura in pregnancy: a reappraisal of management. Obstet Gynecol. 1991;78(4):578-83.

Payne SD, Resnik R, Moore TR, Hedriana HL, Kelly TF. Maternal characteristics and risk of severe neonatal thrombocytopenia and intracranial haemorrhage in pregnancies complicated by autoimmune thrombocytopenia. Am J Obstet Gynecol. 1997;177(1):149-55.