open access

Vol 92, No 8 (2021)
Review paper
Published online: 2021-07-23
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Thrombocytopenia in pregnant women

Monika Ruszala1, Elzbieta Poniedziałek-Czajkowska1, Radzislaw Mierzynski1, Agnieszka Wankowicz2, Aneta Zamojska3, Marek Grzechnik1, Ivan Golubka1, Bozena Leszczynska-Gorzelak1, Marek Gogacz4
DOI: 10.5603/GP.a2021.0147
·
Pubmed: 34541631
·
Ginekol Pol 2021;92(8):587-590.
Affiliations
  1. Public Teaching Hospital No 4, II Department of Gynecology, Lublin, Poland
  2. University Children’s Hospital, Chair and Department of Pediatrics, Pulmonary Diseases and Rheumatology, Lublin, Poland
  3. Medical University of Lublin, Lublin, Poland
  4. Public Teaching Hospital No 4, II Department of Gynecology, Lublin, Poland

open access

Vol 92, No 8 (2021)
REVIEW PAPERS Obstetrics
Published online: 2021-07-23

Abstract

Thrombocytopenia is one of the two most common hematological problems in pregnant women. It is defined as the platelet (PLT) count below 150 × 103/μL. Gestational incidental thrombocytopenia (GIT) represents about 75% of thrombocytopenia cases in pregnancy and it is believed that GIT is secondary to accelerated platelet destruction and increased plasma volume associated with pregnancy. The pregnancy complications such as preeclampsia and its most severe form — HELLP syndrome account for 20% cases of thrombocytopenia in pregnancy and primary immune thrombocytopenic purpura (ITP) — for 3–4 percent. During ITP, maternal antiplatelet antibodies can pass through the placenta and bind to fetal thrombocytes leading to the development of fetal thrombocytopenia which occurs in about 50% cases. Even if the maternal platelet count stabilizes, the estimated fetal and neonatal risk of thrombocytopenia in ITP is approximately 30%. Other types of thrombocytopenia in pregnant women constitute 1–2% of cases (disseminated intravascular coagulation, autoimmunological diseases, congenital, infection and drug-related, concomitant with blood neoplastic diseases). Although thrombocytopenia in pregnant women usually has a mild course, in case of a significant decrease in PLT count may lead to dangerous bleeding, especially when the platelet count falls below 20 × 103/μL.
Since it is important to identify the cause of thrombocytopenia and to determine the risk for both the mother and the child, this paper presents the influence of maternal thrombocytopenia on the pregnancy course as well as its etiology and diagnostics. The treatment principles are discussed.

Abstract

Thrombocytopenia is one of the two most common hematological problems in pregnant women. It is defined as the platelet (PLT) count below 150 × 103/μL. Gestational incidental thrombocytopenia (GIT) represents about 75% of thrombocytopenia cases in pregnancy and it is believed that GIT is secondary to accelerated platelet destruction and increased plasma volume associated with pregnancy. The pregnancy complications such as preeclampsia and its most severe form — HELLP syndrome account for 20% cases of thrombocytopenia in pregnancy and primary immune thrombocytopenic purpura (ITP) — for 3–4 percent. During ITP, maternal antiplatelet antibodies can pass through the placenta and bind to fetal thrombocytes leading to the development of fetal thrombocytopenia which occurs in about 50% cases. Even if the maternal platelet count stabilizes, the estimated fetal and neonatal risk of thrombocytopenia in ITP is approximately 30%. Other types of thrombocytopenia in pregnant women constitute 1–2% of cases (disseminated intravascular coagulation, autoimmunological diseases, congenital, infection and drug-related, concomitant with blood neoplastic diseases). Although thrombocytopenia in pregnant women usually has a mild course, in case of a significant decrease in PLT count may lead to dangerous bleeding, especially when the platelet count falls below 20 × 103/μL.
Since it is important to identify the cause of thrombocytopenia and to determine the risk for both the mother and the child, this paper presents the influence of maternal thrombocytopenia on the pregnancy course as well as its etiology and diagnostics. The treatment principles are discussed.

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Keywords

pregnancy; thrombocytopenia; diagnostic procedures; treatment

About this article
Title

Thrombocytopenia in pregnant women

Journal

Ginekologia Polska

Issue

Vol 92, No 8 (2021)

Article type

Review paper

Pages

587-590

Published online

2021-07-23

DOI

10.5603/GP.a2021.0147

Pubmed

34541631

Bibliographic record

Ginekol Pol 2021;92(8):587-590.

Keywords

pregnancy
thrombocytopenia
diagnostic procedures
treatment

Authors

Monika Ruszala
Elzbieta Poniedziałek-Czajkowska
Radzislaw Mierzynski
Agnieszka Wankowicz
Aneta Zamojska
Marek Grzechnik
Ivan Golubka
Bozena Leszczynska-Gorzelak
Marek Gogacz

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