Obstetric and neonatal outcomes of the pregnancies complicated with thrombocytopenia

ABSTRACT

Background: Thrombocytopenia is second most common hematological abnormality in pregnancy after anemia (Incidence 8-10%). The aim of this study is to observe the obstetric and neonatal outcomes of pregnancies complicated with thrombocytopenia and to compare its maternal and fetal outcomes.Methods: The prospective observational study was conducted at tertiary care institute over period of one and half year and 100 cases of thrombocytopenia in present pregnancy were included after fulfilling inclusion and exclusion criteria and obtaining written informed valid consent. Complete history, physical examination and relevant investigations of the patient were documented. Patients were followed up to delivery and outcomes (obstetric, maternal, fetal, neonatal) were studied. The data obtained for all the patients was analyzed with SPSS (SPSS Inc, Chicago) software packages. Statistical comparisons were performed with Pearson’s Chi- square where appropriate with p-value of <0.05 considered statistically significant.Results: Most common cause of thrombocytopenia in pregnancy was gestational thrombocytopenia in (25%) cases followed by preeclampsia (20%). Most cases (94%) were diagnosed in antepartum period out of which most (58%) at >37 weeks of gestation. Most (53%) had moderate thrombocytopenia. Incidence of maternal complications was statically significant (P-value 0.038) with most common complication being caesarian section site oozing (9%) followed by placental abruption (4%). There was no statistical significance in degree of thrombocytopenia and need for blood and blood product transfusion (P-value 0.67). Only (2%) neonates of thrombocytopenic mothers had thrombocytopenia and both required treatment.Conclusions: Most common cause of thrombocytopenia in pregnancy was gestational thrombocytopenia with uneventful pregnancy and perinatal outcomes. Few severe cases associated with medical or systematic causes leads to serious catastrophic events which can be avoided by increasing antenatal surveillance and appropriate management by multidisciplinary team of obstetrician, hematologist, anesthesiologist, neonatologist and physician.