Thrombocytopenia in Pregnancy and Associated Maternal and Fetal Outcomes in A Tertiary Care Centre

Abstract Background and Objectives: Thrombocytopenia is the second most common hematological abnormality in pregnancy. This research study was undertaken to evaluate the etiology of thrombocytopenia in third trimester of pregnancy & to analyze maternal and fetal outcomes of thrombocytopenia. Methodology: In this observational study 210 females who presented to department of Obstetrics and Gynaecology, Gandhi medical college, Bhopal with thrombocytopenia in their third trimester of pregnancy were enrolled. In all patients history was taken, routine lab tests (Complete blood count, Platelet Count, Liver function test, Renal function test, Coagulation Profile) were done. General and Obsteric examination were done, obstetrical intervention was done when needed. Results: This observational study had 210 participants. Most common cause of thrombocytopenia was found to be gestational thrombocytopenia (69%) followed by pre-eclampsia (14.2%) and dengue (8.1%). Most commonly affected females were multigravida in 20-25 age group. The most common clinical feature seen among the study participants was edema. When comparing the severity of thrombocytopenia, 64.8% of participants had mild thrombocytopenia, 27.6% had moderate thrombocytopenia and 7.6% had severe thrombocytopenia. Out of 201 newborns, 41 of them needed NICU monitoring with Low birth weight and Respiratory Distress syndrome being notable contributors. Maternal mortality was seen in 8 out of 210 cases, most common cause of mortality was HELLP [Hemolysis, Elevated liver enzymes and Low platelets]. Conclusions: The study found that with increasing severity of thrombocytopenia, the percentage of maternal ICU admissions and maternal death increases. Severity of thrombocytopenia is associated with increasing rates of IUFD (Intrauterine Fetal Death), preterm deliveries and NICU admission. Although the incidence of low birth weight and neonatal death increases as the severity of thrombocytopenia in mother increases but association between them is not statistically significant. Thrombocytopenia during pregnancy is an underexplored condition in Indian women and there is an imperative need of more extensive studies in the field.