Evaluation of Outcome of Pregnancy Complicated with Thrombocytopaenia- A Prospective Observational Study

Abstract

Introduction: Thrombocytopaenia occurs in 7-12% of pregnancies at the time of delivery. Knowledge, regarding the causes and effects of thrombocytopaenia on mother and newborn, facilitates proper diagnosis and management of thrombocytopaenia in pregnant women for better maternal and foetal outcomes. Aim: To determine the incidence, causes and outcome of pregnancy with thrombocytopaenia. Materials and Methods: A prospective observational study was conducted among women attending Outpatient Department for an antenatal checkup at NRI Medical College and General Hospital, Chinnakakani, Guntur, Andhra Pradesh, India, from October 2017 to October 2019. A total of 44 antenatal women with platelet count less than 1,50,000/cumm were included in the study. They were followed-up throughout the antenatal period until delivery to record any complications that developed due to low platelet counts in the mother and neonate. A neonatal platelet count was done on day one of life. Data was subjected to statistical analysis using Statistical Package for Social Sciences (SPSS) version 22.0, all qualitative variables were expressed in terms of proportion. Results: A total of 500 cases were studied of which 50 cases had thrombocytopaenia with an incidence of 10%. Out of 50 cases, six were lost for follow-up and the remaining 44 cases were included in the study. Out of 44 patients, 23 (52.27%) had mild thrombocytopaenia, 12 (27.27%) had moderate and 9 (20.46%) had severe thrombocytopaenia at the time of diagnosis. Common causes seen were Gestational Thrombocytopaenia (GT) 17 (38.6%), Preeclampsia (PE) 8 (18.18%), Gestational hypertension 4 (9.09%). A total of 5 (11.36%) required intensive care unit care, 3 (6.81%) had multiorgan dysfunction syndrome (MODS), 2 (4.54%) underwent hysterectomy, 2 (4.54%) had postpartum haemorrhage (PPH), 2 (4.54%) had secondary suturing done for wound infection, 1 patient (2.27%) underwent laparotomy (for rectus sheath haematoma), and mortality was seen in two cases. A total of 14 cases (31.8%) required blood and blood product transfusions. Eight neonates were admitted to the neonatal intensive care unit. There was no case of neonatal thrombocytopaenia. Conclusion: Thrombocytopaenia is a significant problem in pregnancy; hence, the routine antenatal platelet count should be done for a timely diagnosis of thrombocytopenia.

Keywords

• gestational thrombocytopaenia
• haemorrhage
• hypertension