A STUDY OF PREGNANCY EMERGED THROMBOCYTOPENIA AND ITS MATERNAL AND FETAL
OUTCOME.
Abstract
A low platelet count is often an incidental finding in pregnancy. It can
be an indicator of a severe systemic disorder requiring emergent
maternal and fetal care or can just be unique to pregnancy with no harm
to mother or fetus. Physiological decrease in platelet count is seen in
pregnancy due to hemodilution and hypercoagulating state, though the
exact pathophysiology is still unclear. Methods: It is a prospective
observational study done in a tertiary care centre. Results: In about
11,258 cases screened 46 patients had thrombocytopenia (0.4%). The
commonest etiology is found to be gestational thrombocytopenia (n= 21,
45.6%) followed by preeclampsia/ eclampsia/ HELLP syndrome (n=19,
41.3%). Only one patient had ITP and 7(15.3%) were associated with
AFLP. Maximum of them (n= 19, 41.3%) underwent spontaneous vaginal
delivery.4 patients (8.6%) had postpartum haemorrhage, 6 (13.04%) had
ceserean section wound infection, 4 (8.6%) had DIC and 4 (8.6%) had
multiorgan failure.13 patients (28.3%) had platelet count between 40 to
60 thousand per cumm, 11 (23.9%) had between 60 to 80 thousand per
cumm, 10 (21.7%) had between 80,000to 1 lakh and none had their
platelet count less than 20,000 per cumm. Conclusion: Gestational
thrombocytopenia is not a preventable condition. It is an incidental
finding in pregnancy. With strict vigilance during intrapartum and
postpartum period, even without any treatment proper for the same, the
maternal and fetal outcome is found to be good. Key words: HELLP, DIC,
multiorgan failure.