PB0470 - Evaluation of Clinical Characteristics and Outcomes in Gestational Thrombocytopenia in a tertiary care hospital in North India.

Sunday, June 23, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Presenting Author(s)

SW

Sarthak Wadhera, MBBS,MD

Senior Resident, Department of Clinical Hematology and Medical Oncology
Post Graduate Institute of Medical Education and Research
Chandigarh, Chandigarh, India

Co-Author(s)

AS

Aarushi Sahni

Senior Resident, Department of Transfusion Medicine
Post Graduate Institute Of Medical Education And Research
Chandigarh, Chandigarh, India
RN

Rudra Narayan Swain

Senior Resident, Department of Clinical Hematology and Medical Oncology
Post Graduate Institute Of Medical Education And Research
Chandigarh, Chandigarh, India
CS

Charanpreet Singh

Senior Research Associate, Department of Clinical Hematology and Medical Oncology
Post Graduate Institute Of Medical Education And Research
Chandigarh, Chandigarh, India
AK

Amanjot Kaur

Assistant Professor
Department of Obstetrics and Gynaecology
Chandigarh, Chandigarh, India
AJ

Arihant Jain

Associate Professor
Dept of Clinical Hematology and Medical Oncology , PGIMER
Chandigarh, Chandigarh, India
RH

Rekha Hans

Additional Professor
Department of Transfusion Medicine
Chandigarh, Chandigarh, India
GP

Gaurav Prakash

Professor
Department of Clinical Hematology and Medical Oncology
Chandigarh, Chandigarh, India
AK

Alka Rani Khadwal

Professor
Department of Clinical Hematology and Medical Oncology
Chandigarh, Chandigarh, India
RS

Ratti Ram Sharma

Professor
Department of Transfusion Medicine
Chandigarh, Chandigarh, India
VS

Vanita Suri

Professor
Department of Obstetrics and Gynaecology
Chandigarh, Chandigarh, India
RD

Reena Das

Professor
Department of Hematology
Chandigarh, Chandigarh, India
PM

Pankaj Malhotra

Professor
Dept of Clinical Hematology and Medical Oncology , PGIMER
Chandigarh, Chandigarh, India

Background: Gestational Thrombocytopenia (GT), is identified during the second or third trimester of pregnancy, and affects 6-11% of pregnancies. Typically, it is self-limiting and exhibits a nadir platelet count of >50,000/cumm around delivery, resolving within 2-3 weeks postpartum.

Aims: 1. Investigate the clinical characteristics and associated obstetric factors in women diagnosed with GT.
2. Assess maternal and neonatal outcomes in patients with GT.

Methods: A total of 132 pregnant patients with thrombocytopenia admitted for delivery at our institute from March 2023 to December 2023 were screened. Among them, 60 patients with a likely diagnosis of gestational thrombocytopenia were reviewed after excluding those with potential causes such as drugs, sepsis, pre-eclampsia, or HELLP (Haemolysis, Elevated Liver enzymes, and Low Platelets) syndrome. Immune Thrombocytopenia was ruled out based on normal pre-pregnancy or first-trimester platelet counts and recovery of thrombocytopenia within the first 3 weeks after pregnancy termination. Ethical Committee approval was taken for study and retrospective analysis was performed.

Results: Among the 60 patients, median age was 29, and 33% were primigravida. Of these, 35 (58.3 %) had severe thrombocytopenia ( < 50,000/cumm) (Table 1). The median nadir platelet count at the time of delivery was 40,000/cumm (ranging from 6,000 to 1,04,000/cumm). Among multigravida patients, 12.5% had a history of thrombocytopenia in a previous pregnancy that had recovered post pregnancy. Lower Segment Caesarean Section (LSCS) was performed in 41% of cases for obstetric indication, and 66% received SDAP (Single Donor Apheresis Platelet) in the peripartum period. Antepartum haemorrhage occurred in 3 patients, and 1 experienced excessive peripartum bleeding. There was no neonatal complication observed and no neonate exhibited thrombocytopenia.

Conclusion(s): In contrast to existing literature, our findings emphasize a significant proportion of patients with severe thrombocytopenia in gestational thrombocytopenia cases. Importantly, even those with severe thrombocytopenia demonstrated a low incidence (11.4%) of grade >2 or more WHO bleeding.