Publication:

Feto-maternal outcome among cases of thrombocytopenia during pregnancy: an observational study at a tertiary care hospital

Background Thrombocytopenia is decline in the platelet count and second most common haematological aberration secondary to anaemia during pregnancy complicating 7-10% of all pregnancies. Gestational thrombocytopenia contributes to 70-80% of all cases of thrombocytopenia in pregnancy.  Hypertensive disorders accounts for about 15-20% and immune thrombocytopenic purpura for 3-4%.  Other etiologies are considered rare in pregnancy. This research work aims to study prevalence, aetiology and feto-maternal outcomes in cases presenting with thrombocytopenia during pregnancy.

Methods This observational study was conducted over a period of one year from January 2025 to December 2025 at a tertiary care hospital involving 128 pregnant patients visiting indoor of Department of Obstetrics and Gynecology, East Point College of Medical Sciences and Research Centre, Bengaluru. The study includes pregnant women from third trimester with platelet count less than 100000/ul. Any pregnant or non-pregnant woman having diabetes or thrombo-embolic disorders were excluded from the study.

Results Out of 128 patients, moderate thrombocytopenia was seen in 73.4% cases while severe thrombocytopenia in 26.6% cases. Majority of patients had no symptoms and decrease in platelet count was noted on investigation. There are 66 women with Gestational thrombocytopenia, 34 cases with preeclampsia, 13 cases with HELLP syndrome, 06 cases with ITP (Immune Thrombocytopenia Purpura), 3 cases of Hepatitis E and other etiology was seen in 6 cases. The vaginal delivery was carried in about 68 cases, Cesearean section in 29 cases and no delivery in 31 antenatal patients. 3 maternal deaths were seen due to immense blood loss and foetal death accounted in 2 cases due to prematurity and respiratory distress.

Conclusions Maternal and foetal outcomes worsen with severity of thrombocytopenia. Hence, earliest detection of thrombocytopenia by investigations facilitates the prompt management. Management of pregnant women with thrombocytopenia requires multidisciplinary approach with collaboration among the obstetrician, haematologist and hepatologist.