Maternal outcome in pregnancy with thrombocytopenia

Authors

  • Manthan Sojitra Department of Obstetrics and Gynecology, SVPIMSR, Ahmedabad, Gujarat, India
  • Sushma R. Shah Department of Obstetrics and Gynecology, SVPIMSR, Ahmedabad, Gujarat, India
  • Ami V. Mehta Department of Obstetrics and Gynecology, SVPIMSR, Ahmedabad, Gujarat, India
  • Payal P. Panchal Department of Obstetrics and Gynecology, SVPIMSR, Ahmedabad, Gujarat, India
  • Ronak Bhankhar Department of Obstetrics and Gynecology, SVPIMSR, Ahmedabad, Gujarat, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20202729

Keywords:

Gestational hypertension, Maternal outcome, Pregnancy, Thrombocytopenia

Abstract

Background: Thrombocytopenia is second most common haematological abnormality in pregnancy after anemia. The aim of this study was to find out the prevalence, causative factor of thrombocytopenia and to observe the obstetrics outcome of pregnancies complicated with thrombocytopenia.

Methods: This is prospective study of maternal outcome in pregnancy with thrombocytopenia carried out at tertiary care center from February 2019 to January 2020. Out of 350 antenatal screened women, 25 women who were diagnosed with thrombocytopenia, were included in the study.

Results: The incidence of maternal thrombocytopenia in this study was 7.1%. 60% of the women had mild thrombocytopenia while 24% and 16% of women were moderate and severe thrombocytopenic respectively. Amongst 25 thrombocytopenic women 68% had gestational thrombocytopenia, 24% had gestational hypertensive disorder,4% had HELLP syndrome, 4% had immune thrombocytopenic purpura. 60% were delivered vaginally and 40% were delivered by LSCS. The most common indication of LSCS was acute fetal distress (40%) followed by failed induction (30%), breech (10%), and the rest (20%) for other obstetrical indications. The most common indication for induction was pre-eclampsia followed by IUGR, and post-date.

Conclusions: In pregnancy with thrombocytopenia, gestational thrombocytopenia is the commonest and benign condition which does not alter the obstetrical management. Still a vigil 4 should be kept on maternal platelet count in antenatal period to prevent unfavorable outcome in serious conditions that may require specific and urgent management (HELLP syndrome, severe pre-eclampsia, ITP).

Metrics

Metrics Loading ...

References

Saino S, Kekomaki R, Riikonon S, Teramo K. Maternal thrombocytopenia at term: a populationbased study. Acta Obstet Gynecol Scand. 2000;79(9):744-9.

Sullivan CA, Martin JN. Management of the obstetric patient with thrombocytopenia. Clin Obstet Gynecol. 1995;38:521-34.

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

Gernsheimer T, James AH, Stasi R. How I treat thrombocytopenia in pregnancy. Blood. 2013;121(1):38-47.

Richard F, Alexandre H. Thrombocytopenia in pregnancy, 2006. Available at: www.emedicine.medscape.com/article. Accessed on 15th January 2020.

Dwivedi P, Puri M, Nigam A, Agarwal K. Fetomaternal outcome in pregnancy with severe thrombocytopenia. Eur Rev Med Pharmacol Sci. 2012;16(11):1563-6.

Vyas R, Shah S, Yadav P, Patel U. Comparative study of mild versus moderate to severe thrombocytopenia in third trimester of pregnancy in a tertiary care hospital. NHL J Med Sci. 2014;3(1):8-11.

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

Singh N, Amita D, Uma S, Tripathi AK, Pushplata S. Prevalence and characterization of thrombocytopenia in pregnancy in Indian women. Indian J Hematol Blood Transfus. 2012;28(2):77-81.

Ajibola SO, Akinbami A, Rabiu K, Adewunmi A, Dosunmu A, Adewumi A. Gestational thrombocytopaenia among pregnant women in Lagos Nigeria. Niger Med J. 2014;55(2):139-43.

Onisai M, Vladareanu AM, Delcea C, Ciorascu M, Bumbea H, Nicolescu A. Perinatal outcome for pregnancies complicated with thrombocytopenia. J Matern Fetal Neonatal Med. 2012;25(9):1622-6.

Brohi ZP, Perveen U, Sadaf A. Thrombocytopenia in pregnancy: an observational study. Pak J Med. 2013;52(3):67-70.

Lin YH, Lo LM, Hsieh CC, Chiu TH, Hsieh TT, Hung TH. Perinatal outcome in normal pregnant women with incidental thrombocytopenia at delivery. Taiwan J Obstet Gynecol. 2013;52(3):347-50.

Suri V, Aggarwal N, Saxena S, Malhotra P, Varma S. Maternal and perinatal outcome in idiopathic thrombocytopenic purpura (ITP) with pregnancy. Acta Obstet Gynecol Scand. 2006;85(12):1430-5.

Borna S, Borna H, Khazardoost S. Maternal and neonatal outcomes in pregnant women with immune thrombocytopenic purpura. Arch Iran Med. 2006;9(2):115-8.

Turgut A, Demirci O, Demirci E, Uludoğan M. Comparison of maternal and neonatal outcomes in women with HELLP syndrome and women with severe preeclampsia without HELLP syndrome. J Prenat Med. 2010;4(3):51-8.

Jaleel A, Baseer A. Thrombocytopenia in preeclampsia: an earlier detector of HELLP syndrome. J Pak Med Assoc. 1997;47(9):230-2.

Ruggeri M, Schiavotto C, Castaman G, Tosetto A, Rodeghiero F. Gestational thrombocytopenia: a prospective study. Haematol. 1997;82(3):341-2.

Janes SL. Thrombocytopenia in pregnancy. Postgrad Med J. 1992; 68:321-6.

Kasai J, Aoki S, Kamiya N, Hasegawa Y, Kurasawa K, Takahashi T, et al. Clinical features of gestational thrombocytopenia difficult to differenciate from immune thrombocytopenia diagnosed during pregnancy. J Obstet Gynaecol Res. 2015;41(1):44-9.

Bouzari Z, Firoozabadi S, Hasannasab B, Emamimeybodi S, Golsorkhtabar-Amiri M. Maternal and neonatal outcomes in HELLP syndrome, partial HELLP syndrome and severe pre-eclampsia: eleven years’ experience of an obstetric center in the North of Iran. World Applied Sci J. 2013;26(11):1459-63.

Parnas M, Sheiner E, Shoham-Vardi I, Burstein E, Yermiahu T, Levi I, et al. Moderate to severe thrombocytopenia during pregnancy. Eur J Obstet Gynecol Reprod Biol. 2006;128(1-2):163-8.

Turgut A, Demirci O, Demirci E, Uludoğan M. Comparison of maternal and neonatal outcomes in women with HELLP syndrome and women with severe preeclampsia without HELLP syndrome. J Prenat Med. 2010;4(3):51-8.

Habas E, Rayani A, Ganterie R. Thrombocytopenia in hypertensive disorders of pregnancy. J Obstet Gynaecol India. 2013;63(2):96-100.

Pafumi C, Valenti O, Giuffrida L, Colletta G. Gestational thrombocytopenia: does it cause any maternal and /or perinatal morbidity? Cukurova Med J. 2013;38(3):349-57.

Yuce T, Acar D, Kalafat E, Alkilic A, Cetindag E, Soylemez F. Thrombocytopenia in pregnancy: do the time of diagnosis and delivery route affect pregnancy outcome in parturients with idiopathic thrombocytopenic purpura? Int J Hematol. 2014;100(6):540-4.

Ajzenberg N, Dreyfus M, Kaplan C, Yvart J, Weill B, Tchernia G. Pregnancy associated thrombocytopenia revisited: assessment and follow-up of 50 cases. Blood. 1998;92(12):4573-80.

Downloads

Published

2020-06-25

How to Cite

Sojitra, M., Shah, S. R., Mehta, A. V., Panchal, P. P., & Bhankhar, R. (2020). Maternal outcome in pregnancy with thrombocytopenia. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 9(7), 2895–2899. https://doi.org/10.18203/2320-1770.ijrcog20202729

Issue

Section

Original Research Articles