Case Series of Gestational Thrombocytopenia: A Case Study

BACKGROUND: Thrombocytopenia is a frequently encountered hematological abnormality during pregnancy, with gestational thrombocytopenia being the most common cause. Although generally benign, it is essential to differentiate gestational thrombocytopenia from other serious etiologies such as immune thrombocytopenic purpura due to potential adverse maternal and fetal outcomes. Early recognition and appropriate monitoring play a crucial role in ensuring favorable outcomes. AIM: To describe the clinical profile, diagnostic evaluation, management, and maternal outcomes of four cases of thrombocytopenia diagnosed during pregnancy. MATERIALS AND METHODS: This case series includes four pregnant women diagnosed with thrombocytopenia during routine antenatal evaluation and managed at the Department of Obstetrics and Gynecology in Vinayaka Missions Kirupananda Variyar Medical College, Salem. Detailed clinical history, serial platelet monitoring, laboratory investigations, treatment modalities, mode of delivery, and postpartum platelet recovery were documented. Cases were followed through delivery and the immediate postnatal period to assess the maternal outcomes. RESULTS: Among the four cases, three were diagnosed as gestational thrombocytopenia based on late gestational onset, mild-to-moderate thrombocytopenia, absence of bleeding manifestations, and spontaneous normalization of platelet counts in the postpartum period. One case initially suspected as gestational thrombocytopenia was later diagnosed with immune thrombocytopenic purpura due to severe thrombocytopenia, presence of purpura, and persistence of low platelet counts requiring steroid therapy even after delivery. All patients delivered successfully, with appropriate peripartum management including platelet transfusion where indicated. No major adverse maternal outcomes were observed, and neonatal outcomes were satisfactory. CONCLUSION: Gestational thrombocytopenia remains the most common and usually benign cause of thrombocytopenia in pregnancy; however, careful evaluation is essential to exclude other serious causes such as immune thrombocytopenic purpura. Serial platelet monitoring, multidisciplinary management, and individualized treatment strategies contribute to favorable maternal outcomes. This case series emphasizes the importance of vigilant antenatal surveillance and postpartum follow-up in pregnant women with thrombocytopenia.