ABSTRACT
Thrombocytopenia in pregnant women is a common finding. We report a retrospective study of 148 cases over a period of two years. The average age was 30 years. 17% had antecedents of haemorrhagic accidents. Pathologies associated to the thrombocytopenia were dominated by the anaemia and the preeclampsia. The average term of discovery was of 33 weeks of gestation and 4 days. 102 cases were diagnosed in the third trimester. Thrombocytopenia was light in more than half of cases. Only 14 patients [95%] had rates of plaques < 50 000 /mm[3]. Causes of thrombocytopenia were dominated by the gestational thrombocytopenia. It was the etiology in 89 patients [60%]. Preeclampsia and its complications were in second position. Gestational thrombocytopenia was followed in a regular way by platelet counts. Thrombocytopenia in complications of the preeclampsia [HELLP syndrome] impose an interruption of the pregnancy. The immune thrombocytopenia < 30 000 / mm[3] and the one that was symptomatic benefited from corticosteroids. Haemorrhagic complications were observed in 43 patients [31,5%]. 15 patients [10%] were transferred in a unity of intensive care. No case of maternal mortality was recorded. Delivery was by natural way in 69% of cases, instrumental in 7,4% of cases and by caesarean section in 23,6% of cases. General anesthesia was realized in 95% of cases. Percutaneous umbilical blood sampling was not realized at any patient. No neonatal haemorrhagic complication was observed. The association thrombocytopenia and pregnancy is of high risk. It can be at the origin of haemorrhagic complications involving maternal and fetal vital preview. The coverage requires a multidisciplinary cooperation between obstetrician, haematologist, pediatrician and anaesthesist