Thrombocytopenia in pregnancy; cause evaluation and follow-up
DOI:
https://doi.org/10.55629/pakjpathol.v36i4.876Abstract
Objective: To determine the various causes of thrombocytopenia in pregnancy and its outcome.
Material and Methods: This quasi-experimental study was conducted at the tertiary care setup Combined Military Hospital Malir, Karachi, over three years. Pregnant women with a platelet count <150 × 10⁹/L were enrolled, evaluated for the cause of thrombocytopenia, and followed until delivery and the postpartum period. Clinical history, including gestational age, age, comorbidities, and drug use, were recorded. Peripheral blood smears and relevant laboratory investigations (including Coombs test, liver and renal function tests, urine protein, HBsAg, and anti-HCV) were performed to determine the etiology.
Results: A total of 160 females were recruited in study. Thrombocytopenia in pregnancy is most commonly caused by gestational thrombocytopenia, seen in 120 cases (75.0%), and is usually mild and harmless. Pre-eclampsia and HELLP syndrome account for 16 cases (10.0%) and are serious conditions requiring close monitoring. DIC (disseminated intravascular coagulation), a life-threatening clotting disorder, was found in 4 cases (2.5%). Hepatic diseases, such as liver dysfunction, contributed to 2 cases (1.2%). Infections like malaria and dengue were responsible for 7 cases (4.4%). Autoimmune causes included ITP 4 cases (2.5%), TTP 3 cases (1.9%), and APLA 1 case (0.6%). Other causes were seen in 3 cases (1.9%).
Conclusions: Maternal outcome can be improved if exact cause is diagnosed during pregnancy. For most of the cases only reassurance is required.
Keywords: Gestational thrombocytopenia, Pregnancy, Thrombocytopenia
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