PB0484 - Thrombocytopenia in pregnancy; cause, evaluation and follow up

Background: Thrombocytopenia is the second most common haematological disorder of pregnancy. Various causes ranging from benign thrombocytopenia to potentially life threatening disorders like preeclampsia, eclampsia, thrombotic thrombocytopenic purpura etc. are examined. Timely identification of underlying etiology is crucial for appropriate management ensuring, wellbeing of both the mother and the baby.

Aims: To determine the various causes of thrombocytopenia in pregnancy and its outcome

Methods: This prospective study was carried out in tertiary care Combined Military Hospital Malir Karachi. All pregnant females with platelet count less than 150 x 10 /l were recruited in the study. They were evaluated for the cause and were followed up till the safe delivery and postpartum. History of onset of thrombocytopenia, duration of pregnancy, age, past medical and surgical history, any co-morbid conditions and drug history was taken.
Peripheral blood slides were examined for confirmation of thrombocytopenia, red blood cells fragmentation, malarial parasite and abnormal white blood cells. Relevant other laboratory investigations were also carried out to evaluate the cause of thrombocytopenia such as Coombs test, liver function test, renal function test, urine for protein, HbsAg, anti HCV etc.

Results: A total of 160 females were recruited in study. Gestational thrombocytopenia was the commonest cause (77.3 %), incidence of thrombocytopenia due to preeclampsia / eclampsia/ placental abruption / HELLP was (10%), DIC (2.66%), Hepatitis (1.33%), malaria and dengue (4.5%), Thrombotic thrombocytopenic purpura (1.87%) anti phospholipid antibody syndrome (0.6%) and ITP was (1.33%).

Conclusion(s): Maternal outcome can be improved if exact cause is diagnosed during pregnancy. For most of the cases only reassurance is required.