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To find the prevalence and causes of thrombocytopenia during pregnancy. An analytical prospective observational study was conducted in Department of Obstetrics & Gynecology, CSMMU, Lucknow. 1079 antenatal women screened for thrombocytopenia and investigated for cause and management strategies and fetomaternal outcome were recorded. Prevalence of th...
Citations
... Thrombocytopenia, defined as a platelet count of < 150 × 10 9 /L, occurs in approximately one in every 10 to 15 pregnancies. [1,2] The most common etiology is gestational thrombocytopenia, which frequently occurs during the last trimester of pregnancy, accounting for nearly 3-quarters of all cases of thrombocytopenia. [3,4] Other causes include preeclampsia, hemolysis, elevated liver enzymes, low platelet (HELLP) syndrome, viral infections, systemic lupus erythematosus, immune thrombocytopenic purpura (ITP), sepsis, disseminated intravascular coagulation, microangiopathies such as hemolytic uremic syndrome, and drug-induced thrombocytopenia. ...
... Hence, it is challenging to predict the course of thrombocytopenia in neonates, and close follow-up is essential. Severity, n (%) Mild (100-149 × 10 9 /L) Moderate (50-99 × 10 9 /L) Severe (21-49 × 10 9 /L) Very severe (≤20 × 10 9 /L) Determination time, hour, Mean ± SD, (range) Nadir of platelet counts, days, Mean ± SD, (range) Recovery, days, Mean ± SD, (range) 8 (47.1%) 1 (5.9%) 2 (11.8%) 6 (35.3%) 11 ± 7.6 (1-50) 3.1 ± 2.8 (1-7) 6.9 ± 2.7 (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) Need for treatment, n ( In 2 studies conducted on 67 and 27 mothers with ITP and their babies, the median recovery time of neonatal thrombocytopenia was 11 (3-58 days) and 7 days (2-120 days), respectively. [17,25] In our study, neonatal platelet counts normalized at a mean of 6.9 ± 2.7 days (1-14 days), with the most extended duration in the newborn baby whose mother had a history of splenectomy. ...
Immune thrombocytopenic purpura (ITP) comprises ~1% to 4% of thrombocytopenia cases during pregnancy. Factors predicting neonatal thrombocytopenia and associated morbidities due to maternal ITP are unclear. The present study aimed to assess the neonatal outcomes of pregnant women with ITP. Fifty-five pregnant women with ITP and their babies, born between January/2013 and April/2021, were retrospectively reviewed. Maternal and neonatal thrombocytopenia cases other than ITP were excluded from the study. Physical examination, blood count, and cranial/abdominal ultrasonography findings of the newborns were recorded. Neonatal thrombocytopenia was defined as a platelet count < 150 × 10 9/ L. Relationship between neonatal thrombocytopenia and maternal factors was investigated. Thrombocytopenia was detected in 17/55 babies (30.9%), and 8/17 (47.1%) had symptoms of bleeding, all but one being mild bleeding. There was a significant correlation between neonatal platelet counts of < 100 × 10 ⁹ /L and maternal splenectomy history. Incidence of moderate and severe thrombocytopenia was higher (statistically insignificant) in neonates of mothers with ITP. No significant correlation was determined between maternal and neonatal platelet counts. There was a weak insignificant correlation between platelet counts of neonates of mothers with or without thrombocytopenia. A significant correlation was found between the presence of splenectomy before delivery in the mother and a platelet count of < 100 × 10 ⁹ /L in the neonate. Moderate and severe thrombocytopenia was higher in neonates of mothers diagnosed with ITP before pregnancy and needed treatment during pregnancy and/or delivery, but the difference was insignificant. Close follow-up of babies born to mothers with ITP after birth is crucial since there is no significant prediction criterion for developing neonatal thrombocytopenia and associated morbidities.
... In this study, the prevalence of thrombocytopenia among pregnant women was 24 [9,27,[37][38][39][40][41][42][43][44] and lower than the studies conducted in China (28.2%) [45]. The difference might be due to socio-demographic differences in the study subject, differences in the study design, geographical variation, availability and accessibility of health care facilities, health-seeking behaviours, genetic variation related to pregnancy, a diagnostic method used, and differences in dietary habits of the study populations. ...
Background
Thrombocytopenia in pregnancy is a common multifactorial abnormality of the hematological system, next to anemia. It leads to more increased risk of bleeding during delivery, labour, or the postpartum period. Despite being a significant public health concern, there are limited studies done concerning thrombocytopenia during pregnancy.
Objective
To assess the magnitude and associated factors of thrombocytopenia among pregnant women at Mizan Tepi University Teaching Hospital from September 2023 to November 2023.
Methods
An institutional-based cross-sectional study was carried out on 230 systematic randomly selected pregnant women who attended antenatal visits from September 2023 to November 2023 G.C using data collection tools. The pretested structured questionnaires were employed to obtain clinical, nutritional, and sociodemographic information. Additionally, three millilitres of venous blood were collected from each participant and analyzed using a Sysmex hematology analyzer. The data was entered into Epidata version 4.6 and analyzed using STATA version 14. Descriptive statistics were computed, and logistic regression was used to identify predictors with a significance level of less than 0.05.
Results
Two hundred thirty pregnant women participated in the study. Among study participants, the magnitude of thrombocytopenia was 55(24.35%) with 32 (57.14%) mild, 19 (33.93%) moderate, and 5 (8.93%) severe thrombocytopenia. The determinant factors which shown significant association were Malaria parasite infection (AOR 9.27 at 95% CI 7.42, 10.87), one-year Inter-birth interval (AOR 1.7 at 95% CI 1.24, 2.14), History of abortion (AOR 3.94 95% CI 3.13, 4.86), History of hypertension (AOR 3.12 95% CI 1.56, 4.12), HIV infection (AOR 1.81 95% CI 1.32.2.52) and HBV infection (AOR 3.0 95% CI 2.82, 3.34).
Conclusion
Thrombocytopenia is a public health problem and mild type of thrombocytopenia was the most predominant. The determinant factors that showed significant association with thrombocytopenia were Malaria Parasitic infection, one-year Inter-birth interval, History of abortion, History of hypertension, HIV infection, and HBV infection. Therefore, pregnant women should be continuously screened for thrombocytopenia to avoid excessive bleeding. Increasing Inter-birth interval, preventing abortion as well as timely diagnosis and treatment of underlying causes such as malaria infection, hypertension, HBV, and HIV is important to reduce the burden of thrombocytopenia.
... Te present study showed a greater incidence of thrombocytopenia than the studies conducted in Ethiopia (7.7-9.9%) [17,18,29], India (8.8%) [30], Libya (8.3%) [31], and Baghdad (7.1%) [32]. Te diference in the prevalence of thrombocytopenia might be due to diferences in sociodemographics, sample size, variability of the automated analyzer, geographical variation, or lifestyle. ...
Background
Thrombocytopenia is the second most common hematological disorder in pregnancy after anemia worldwide and affects 7-8% of all pregnancies. Pregnant women with thrombocytopenia have complications of excessive bleeding during or after childbirth, exudation at the cesarean section, and neonatal thrombocytopenia. Therefore, the main aim of this study was to assess the magnitude of thrombocytopenia and its associated factors among pregnant women attending the Antenatal Care Service Unit of Wachemo University Nigist Ellen Mohammed Comprehensive Specialized Hospital Hosanna, Southern Ethiopia.
Materials and Methods
A cross-sectional study was conducted from June 1 to August 30, 2022, involving 209 consecutive pregnant women who came to the hospital during the study period for antenatal care follow-up. Sociodemographic, reproductive, and other clinical data were collected using a structured questionnaire. A four-milliliter venous blood specimen was collected for complete blood analysis and peripheral blood smear. The data were analyzed by using SPSS version 25. Descriptive statistical analysis and bivariate and multivariate logistic regression analyses were performed. A P value ≤0.05 was considered to indicate statistical significance.
Results
The overall magnitude of thrombocytopenia among pregnant women was 14.8% (95% CI: 10, 19.6). The prevalence of mild, moderate, and severe thrombocytopenia was 77.4%, 16.1%, and 6.5%, respectively. Multivariate logistic regression revealed that rural residence (AOR = 2.6 and 95% CI = 1.02, 7.12), cigarette smoking (AOR = 8.4 and 95% CI = 1.86, 38), anemia (AOR = 8.3 and 95% CI = 2.7, 25.6), and alcohol consumption (AOR = 8.2 and 95% CI = 2.17–31) were significantly independent factors associated with the development of thrombocytopenia.
Conclusion
The magnitude of thrombocytopenia in this study was 14.8%. Rural residence, cigarette smoking, alcohol consumption, and anemia were significantly associated with thrombocytopenia. Therefore, the platelet count should be routinely determined during antenatal care visits for proper diagnosis and to minimize bleeding during and/or after childbirth.
... It was further followed by ITP (11.11%) and dengue (5.5%). [7] As per study by Singh N et al (2012) Gestational thrombocytopenia was seen in 64.2%, obstetric in 22.1% and medical in 13.68% cases. ...
... The drains were removed after post operative day 3 when there was less than 50cc output over 24hrs.. [5] According to study by Borhany M et al out of the total of 150, 78 (52%) were through normal delivery while 67 (44.6%) patients underwent casrean section. [7] As per study by Singh N et al (2012) the lower segment casrean section was done for 67 (46.21%) women and 78 (53.79%) women had normal vaginal delivery. 90 (62.07%) women had no complications. ...
Introduction: Gestational thrombocytopenia is dened as platelet count less than 1,50,000/μl and forms the second most common cause of hematological disorders in pregnancy. The women with thrombocytopenia in pregnancy need to be carefully evaluated and the causes determined. Methodology: It is a hospital based prospective observational study conducted over a period of 6 months. All pregnant women attending OPD at the department of obstetrics and gynecology, SMS Medical College, Jaipur for antenatal checkup were included for the study and blood sample was taken. Result: The 145( incidence-36.25%) pregnant women with thrombocytopenia attending the antenatal clinic were included in the study. The most common cause of thrombocytopenia in pregnancy was gestational thrombocytopenia seen in 75 (51.72%) women, followed by hypertensive disorders in 46 ( 31.72%) women. The coagulopathy was seen in 12 (8.28%) women, hepatic disease in 6 (4.14%) women. 5(3.45%) women had dengue IgM positive and 1 woman was diagnosed with ITP. Conclusion: The gestational thrombocytopenia is the most common benign cause of thrombocytopenia in pregnancy. The women with thrombocytopenia require careful monitoring to improve the fetomaternal outcome.
... [33,34] The finding is also supported by a recent systematic review and meta-analysis, which showed that around one-tenth of pregnant women are affected by TCP globally. [4] However, the prevalence of TCP in the present study is slightly higher than the global estimate and other previous reports from India 8.8%, [35] and Ethiopia 7.7% to 8.8%. [6,22] These imply that TCP has a high burden on pregnant women and needs major concern to avoid the occurrence of adverse outcomes in pregnant women regardless of geographical locations. ...
Thrombocytopenia (TCP) is the second most common hematological change during pregnancy and is considered as a major source of maternal and neonatal morbidity and mortality. Despite its effects to morbidity and mortality, it is frequently ignored or disregarded, particularly in resource-limited nations. Thus, the purpose of this study was to determine the prevalence of thrombocytopenia and associated factors among pregnant women attending antenatal care at Hiwot Fana Comprehensive Specialized University Hospital, Eastern Ethiopia from June 20 to August 30, 2022. A hospital-based cross-sectional study was conducted among 199 pregnant women selected through a systematic sampling technique. Ethical approval was obtained from the Ethics Review Committee of Haramaya University. Data related to sociodemographic and reproductive variables were collected using structured questionnaires. Four milliliters of venous blood were collected from each study participant and a complete blood cell count was determined using UniCel DxH 800 hematology analyzer. Logistic regression analysis was done to assess the association between TCP and independent variables and P < .05 was considered statistically significant. In this study, the prevalence of TCP was 14.1% (95% CI: 9.6–19.7). Of them, 10 (35.7%), 12 (42.9%), and 4 (21.4%) had mild, moderate, and severe TCP, respectively. Having more than 3 children (adjusted odds ratio, AOR = 7.90, 95% CI: 2.60, 24.3), no antenatal care follow-up (AOR = 7.90, 95% CI: 2.40–26.2), being in the second and third trimester (AOR = 6.90, 95% CI: 1.70, 28.9 and AOR = 5.04, 95% CI: 1.12, 22.7, respectively), and history of heavy menstrual bleeding (AOR = 4.03, 95% CI: 1.25, 13.1) were significantly associated with TCP. TCP is a public health problem among pregnant women in the study area. Having more than 3 children, lack of antenatal care follow-up, being in the second and third trimesters, and having history of heavy menstrual bleeding was significantly associated with TCP. As a result, regular platelet count monitoring and appropriate intervention approaches based on identified predictors should be explored to mitigate adverse outcomes in pregnant women.
... The majority of studies mention concomitant results. Nisha et al. show that normal vaginal delivery occurred in 61.54% of patients and caesarean section was performed in 36.26% of patients [28]. ...
Essential thrombocythemia is a hematological problem that occurs during pregnancy. Diagnosis of essential thrombocythemia is difficult because it is a diagnosis of exclusion and there is a higher frequency of thrombocythemia due to other causes. A 26-year-old female patient with G1P0000 gestational weeks 30–31 came to the gynecology clinic after laboratory examination with thrombocyte count of 1,128,000 μL. There were no complaints of dizziness, nausea, vomiting, tingling, or fever. She was fatigue with compos mentis consciousness, with blood pressure 110/70 mmHg, heart rate 85 times/minute, respiratory rate 20 times/minute, and temperature 36.5 °C. Head to toe examination was within normal limits. An obstetric status examination was obtained. Fundal height: 3 fingers below the xiphoid process (31 cm, with estimation fetal weight by McD formula 2945 grams) and fetal heart rate 134 times/minute. Blood smear shows leukocytosis and thrombocythemia suspected myeloproliferative disorder (MPD), an essential thrombocythemia. She was tested for the JAK2V617F mutation but no mutation was detected. Doppler ultrasound test shows umbilical artery (RI: 0.69; PI: 0.95; S/D ratio: 2.76) and middle cerebral artery (RI: 0.74; PI: 1.48; S/D ratio 3.88). She was consulted to hematooncologist and was given aspirin 80 mg per day, Cal-95 1 tablet per day, and prenatal vitamins. Evaluation of patients with essential thrombocythemia includes a complete blood count, bone marrow biopsy, and genetic testing to evaluate gene mutations to obtain the appropriate diagnosis and therapy to prevent from its complication such as thrombosis during pregnancy, bleeding during pregnancy, gestational hypertension, preeclampsia, eclampsia, prematurity, placental abruption, intrauterine growth retardation and stillbirth.
... This is similar to the study by Nisha et al (7) The average gestation in severe thrombocytopenia group was 36+6 weeks as opposed to 38 weeks in moderate thrombocytopenia group with 21% preterm delivery. The preterm delivery rate (31.8%) among thrombocytopenia was higher than that (11.6%) in general population in the study by Nisha et al. (7). This was associated with obstetric and medical complications. ...
Thrombocytopenia can be seen in pregnancy with the most common cause being gestational thrombocytopenia. However, in presence of other secondary co-morbidities the thrombocytopenia can have a big impact on the care of the women in labor. Aplatelet count of less than 100 X109/L can be seen in around 1% pregnant women. In this study we aim to study the intrapartum outcome of women with platelet count <100,000/microL admitted to a tertiary care unit over a period of 1 year. 75% women with severe thrombocytopenia (<50,000/microL) had some associated comorbidities. While cesarean section was done mostly for obstetric reasons, 66% were done under general anesthesia. All the patients in severe thrombocytopenia group required blood and blood products transfusion. This besides helping us improve management of these women also would help us plan and strengthen the manpower and resources for management of such high-risk women.
... This condition could potentially lead to coagulopathy and a series of adverse events in these neonates [69]. Indeed, further optimization of therapeutic hypothermia (TH) in these countries is crucial, especially considering the higher susceptibility to thrombocytopenia observed in women in these regions during pregnancy [70]. Hence, tailoring TH protocols to the population's specific needs and characteristics can lead to better outcomes and minimize the risk of complications like thrombocytopenia and cardiac arrhythmia. ...
Neonatal hypoxic-ischemic encephalopathy (HIE) is a condition that results in brain damage in newborns due to insufficient blood and oxygen supply during or after birth. HIE is a major cause of neurological disability and mortality in newborns, with over one million neonatal deaths occurring annually worldwide. The severity of brain injury and the outcome of HIE depends on several factors, including the cause of oxygen deprivation, brain maturity, regional blood flow, and maternal health conditions. HIE is classified into mild, moderate, and severe categories based on the extent of brain damage and resulting neurological issues. The pathophysiology of HIE involves different phases, including the primary phase, latent phase, secondary phase, and tertiary phase. The primary and secondary phases are characterized by episodes of energy and cell metabolism failures, increased cytotoxicity and apoptosis, and activated microglia and inflammation in the brain. A tertiary phase occurs if the brain injury persists, characterized by reduced neural plasticity and neuronal loss. Understanding the cellular and molecular aspects of the different phases of HIE is crucial for developing new interventions and therapeutics. This review aims to discuss the pathophysiology of HIE, therapeutic hypothermia (TH), the only approved therapy for HIE, ongoing developments of adjuvants for TH, and potential future drugs for HIE.
... In this study, the prevalence of thrombocytopenia among pregnant women with malaria was 20%, which was almost comparable to the result of study conducted by Parnas et al., (2006) that reported prevalence of 21.8% [22] . However, the result of this study was slightly higher than result of studies conducted by Boehlen et al., [23][24][25][26] . ...
Thrombocytopenia is a condition that occurs when platelet count is below 150,000 platelets per microlitre of circulating blood. The assumed structure that cause thrombocytopenia during malaria infection are: the involvement of platelet as cofactor in causing severe malaria, coagulation disruptions, bone marrow changes, splenomegaly, oxidative stress and antibody-mediated platelet destruction. The aim of the study was to determine the platelet count and platelet indices of pregnant women infected with malaria parasite. Sixty five pregnant women identified as positive for malaria by microscopy (PfMbM), twenty five pregnant women identified as negative for malaria by microscopy (NfMbM) and twenty six non-pregnant women were enrolled. Platelet count (PC), mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), platelet-large cell ratio (P-LCR), platelet large cell coefficient (P-LCC) and total white blood cell count (TWBC) were measured by automated haematology analyzer. The case control study was conducted between June and September 2022. Among 65 pregnant women identified as PfMbM, 6 (9.2%) had mild thrombocytopenia (100-<150 x 10 9 /L), 4 (6.2%) had moderate thrombocytopenia (50-<100 x10 9 /L) and 3 (4.6%) had severe thrombocytopenia (<50 x 10 9 /L). P-LCC levels were 67.33 ± 19.05 x10 3 /µl in pregnant women identified as PfMbM and 57.76 ± 15.74 x10 3 /µl in control group p=.0.003. Platelet counts were 295.13 ± 95.00 x 10 9 /L in NfMbM group and 233.50 ± 106.64 x 10 9 /l in PfMbM group p=<0.001, whereas P-LCC were 67.33 ± 19.05 x10 3 /µl in PfMbM and 74.89 ±23.68 x10 3 /µl in NfMbM group p=0.018. Also PC were 279.24 ± 82.16 x 10 9 /L in PfMbM with one plus and 234.71 ± 84.14 x 10 9 /L PfMbM group with two pluses p=0.022. The comparison between the first, second and third trimester showed significant decrease in PC 176.19 ± 77.51 x 10 9 /L in third trimester compared to first trimester 225.17 ± 51.51 x 10 9 /l p=0.049. The study showed presence of mild, moderate and severe thrombocytopenia, significant increase in platelet large cell coefficient in pregnant women identified as positive for malaria by microscopy The study recommends regular malaria test and platelet count in pregnant women during antenatal period.
... [1][2][3][4] The most prevalent haematological disorder in pregnancy, it is second only to anaemia. [5][6][7] Gestational thrombocytopenia is condition with platelets count less than 50000 in a pregnant women, the incidence is asymptomatic and occurs in second half of pregnancy, 8,9 in the absence of history of thrombocytopenia the of platelets count returns to normal level within two months of postpartum. 10,11 The gestational thrombocytopenia is not associated with maternal or fetal risk. ...
: Pregnancy is a wonderful event of a women life, where in a female prepare herself to give birth to child. The physiological changes in blood include a rise in erythrocytes and a decrease in platelets, which results in the condition known as thrombocytopenia, where the platelet counts are fewer than a few lakhs and bring on bleeding symptoms. The decreased platelet during pregnancy is called gestational thrombocytopenia.
: The present study aims to find the prevalence of the gestational thrombocytopenia in India.
A cross sectional descriptive study design used to identify the prevalence rate of the gestational thrombocytopenia in India, total 3952 samples from India like Lucknow, Panipat, Sonipat, Gohana, Delhi.
The study found that the prevalence of gestational thrombocytopenia is 3.4%. During the study period records revealed that 37 women (27%) belonged to gestational age of 30-33 weeks, 30 women (21%) belonged to gestational age of 34-36 weeks and 70 women (51%) belonged to gestational age of 37-40 weeks. Thirty-five (25.5%) cases had mild thrombocytopenia, 22 women (16%) had moderate, and 80 women (58.7%) had severe thrombocytopenia.
: The present study assessed the prevalence of the gestational thrombocytopenia at various cities in India, suggested the importance of the early identification of gestational thrombocytopenia and prevention of complications related to gestation and pregnancy outcome
