Successful management of recurrent gestational thrombocytopenia with Chinese herbal medicine: a case report and literature review

Background: Gestational thrombocytopenia (GT) represents the most prevalent cause of thrombocytopenia during pregnancy, generally manifesting in the third trimester and resolving spontaneously following delivery. Nevertheless, its management primarily involves supportive care, as effective therapeutic options are limited. Case presentation: A 30-year-old woman experienced recurrent GT in two consecutive pregnancies. Thrombocytopenia developed unusually early, during the first and second trimesters, and progressively worsened. After non-pharmacologic interventions failed to prevent the decline, a modified traditional Chinese herbal decoction was administered. In the second pregnancy, the platelet count increased from 72,000/μL to 135,000/μL after 13 doses, while in the third pregnancy, it rose from 64,000/μL to 111,000/μL after 35 doses. Both pregnancies culminated in full-term vaginal deliveries of healthy infants. The patient experienced no maternal or neonatal complications, and she reported reduced anxiety regarding thrombocytopenia and delivery during follow-up. Conclusion: This single case suggests that adjunctive traditional Chinese medicine (TCM) was associated with improved platelet counts and enhanced self-reported emotional wellbeing in a woman with recurrent GT, and may inform shared decision-making about mode of delivery. Additional clinical studies are required to confirm the safety and efficacy of TCM for pregnancy-related thrombocytopenia.