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Abstract
Thrombocytopenia is defined as a platelet count of less than 150.000/cmm. Platelet counts less than 50.000/cmm may also increase surgical bleeding. The risk of spontaneous bleeding increase only when platelet counts fall below 20.000/cmm. Thrombocytopenia is second only to anemia as the most common haematologic abnormality during pregnancy. Some causes are unique to pregnancy, whereas others can be serious medical conditions that have been previously undiagnosed. Thrombocytopenia, depending on the severity and etiology, may or may not be associated with adverse outcomes with serious maternal and fetal morbidity and mortality.
The most common cause of Thrombocytopenia in pregnancy is gestational thrombocytopenia, which is characterized by platelet count usually more than 80,000/cmm; which returns to a normal level following delivery within twelve weeks. Women are asymptomatic with no history of bleeding, and thrombocytopenia is usually detected as a part of antenatal screening. The women have no history of thrombocytopenia prior to pregnancy but may had thrombocytopenia in previous pregnancies.
Gestational thrombocytopenia is a diagnosis of exclusion, usually occurs in the late second or third trimester.
In recent years, a big body of knowledge is accumulating, highlighting thrombocytopenia in pregnancy. Stemming from the risks, both maternal and fetal, of overlooked thrombocytopenia during pregnancy, this study was designed to tackle this issue.
The main objective was to screen women with normal pregnancy in the third trimester for pregnancy associated maternal thrombocytopenia, and to evaluate the effect of thrombocytopenia on both the mother and the fetus.
The study was conducted on 100 gravidas in the third trimester with normal pregnancy; recruited from antenatal clinic of El-Shatby Maternity University Hospital after fulfilling the inclusion criteria and they were subjected to history taking, examination, laboratory investigations and ultrasonography.
Patients were allotted into two groups according to their platelet count; the first group included 95 gravidas with normal platelet count and the second groups included 5 patients with gestational thrombocytopenia having platelet counts less than 150,000/cmm.
The current study revealed that gestational thrombocytopenia accounts fro 5% of study cases. The mean platelet count was significantly higher in normal platelet count group (208.1350.82×103 cmm) as compared to thrombocytopenic group (107.020.4×103/cmm).
There was no significant difference between both groups as regards age, gravidity, parity, haemoglobin concentration, white blood cells, PT, PTT, liver enzymes, renal function, anticardiolipin antibodies, lupus anticoagulant, there was also no significant difference as regards mode of delivery whether vaginal or cesarean section and there was no cases with postpartum haemorrhage. The Apgar score and fetal examination after delivery showed no significant difference.