To Study Feto-Maternal Outcome in Pregnancy with Thrombocytopenia

Background & Objective: Platelets are an important component of the body’s hemostatic mechanism and play a vital role at every stage of pregnancy, including, placentation, pregnancy maintenance, and control of bleeding after parturition. Thrombocytopenia, defined as a platelet count lower than 150,000/mcl, is the second most common hematological condition after anemia, which complicates 10% of pregnancies. Gestational thrombocytopenia often found in the third trimester as an incidental finding is a self-limiting condition without any clinical presentation and recovers after delivery. Pathological thrombocytopenia as seen in preeclampsia, HELLP syndrome, acute fatty liver of pregnancy, DIC, drugs, etc. is associated with adverse pregnancy outcomes. This study is aimed to assess feto-maternal complications in pregnancies complicated by thrombocytopenia according to etiology. Materials & Methods: This study was done prospectively for one year in 100 pregnant women with thrombocytopenia. Clinical course: Mode of delivery along with perinatal and maternal complications were noted. Results: We found 66% of women with low platelets have gestational thrombocytopenia, 20% with pre-eclampsia and HELLP syndrome, 7 % with chronic hypertension, 5% with dengue and 2% with AFLP. The maternal complications were postpartum hemorrhage, placental abruption, and wound hematoma. Fetal complications were low birth weight, stillbirth and NICU admission. Most complications were seen with preeclamptic women. Conclusion: The most common cause of low platelet count in pregnancy is gestational thrombocytopenia. Feto-maternal complication rates in Gestational thrombocytopenia are significantly low when compared to the groups where thrombocytopenia is associated with Pre-Eclampsia, Eclampsia, HELLP Syndrome, AFLP, Dengue Fever and Chronic hypertension.