Exploring the Patterns of Thrombocytopenia in Pregnancy: unravelling Implications and Outcomes

• Manju Mathesan,*  
• shanthi ethirajan

Abstract

Introduction: Thrombocytopenia, characterized by reduced platelet count, is a hematological disorder that can manifest during pregnancy, posing challenges in maternal-fetal outcomes. The intricate physiological changes of pregnancy and underlying medical conditions contribute to the complexity of thrombocytopenia, impacting both maternal health and fetal outcomes. Objective: To comprehensively understand the spectrum of thrombocytopenia during pregnancy, investigating its causes, and outcomes. The study aims to identify risk factors, patterns, and associations with adverse maternal and fetal outcomes. Methods: A prospective observational study conducted from March 2022 to November 2023 at Saveetha Medical College. Participants included pregnant women aged 18-40 got admitted as in patient in obstetrics and gynaecology department. Regular blood tests assessed platelet counts, with additional data collected on demographics, medical history, and lifestyle. Maternal outcomes (bleeding, preeclampsia) and fetal/neonatal outcomes (birth weight, gestational age, nicu admission ) were monitored. Statistical analysis employed descriptive statistics and regression analysis. Results: Out of 1980 deliveries, 88 patients (4.4%) had thrombocytopenia. Causes included gestational thrombocytopenia (42%), dengue (32%), severe pre-eclampsia (11%), eclampsia (6%), immune thrombocytopenia (4%), scrub typhus (2%), HELLP syndrome (2%), and partial HELLP syndrome (1%). Gestational thrombocytopenia and dengue were the predominant contributors. Temporal distribution revealed 77% of diagnoses in the third trimester, emphasizing late pregnancy onset. Thrombocytopenia severity showed 69% mild, 30% moderate, and 1% severe cases. Primiparous women were more likely to present with severe thrombocytopenia (p=0.03). A subset (14%) required platelet transfusion, highlighting clinical significance. Perinatal outcomes depends upon the causes of thrombocytopenia in mother which includes fetal growth retardation (9%), neonatal thrombocytopenia (4%), birth asphyxia (3%), and intrauterine death (2%). Conclusion: This study contributes comprehensive insights into thrombocytopenia during pregnancy, identifying diverse causes and highlighting the importance of tailored monitoring. The findings inform clinical practice, enhance prenatal care, and emphasize the need for early detection and individualized interventions. Future research can build upon these insights to refine risk assessment, diagnostics, and therapeutic strategies, advancing efforts in managing thrombocytopenia during pregnancy.

Keywords

Thrombocytopenia,pregnancy,materanl,fetal outcome