Evaluation of Etiological Factors of Thrombocytopenia in Pregnancy and its Effects on Feto-Maternal Outcomes
Authors/Creators
- 1. Department of Obstetrics and Gynaecology, King George's Medical University, Uttar Pradesh Lucknow, India
- 2. Department of Biochemistry, King George's Medical University, Uttar Pradesh Lucknow, India
Description
Background: Thrombocytopenia is defined as a platelet count of less than 150×109/L, or the 2.5th lower percentile of the normal platelet count distribution. Aim of the study was to evaluate the etiological Factors of Thrombocytopenia in pregnancy and its effects on feto-maternal Outcomes. Material and Methods: The prospective observational study was done from September 2020 to October 2021 on one hundred fifty-eight pregnant females with low platelet count or who were diagnosed as thrombocytopenia in second and third trimester at QMH, Department of Obstetrics and Gynaecology, King George’s Medical University, Lucknow. The Chi-square test will be used to compare the categorical variables. The Unpaired t-test was used to compare the continuous variables. The p-value<0.05 was considered significant. All the analysis was carried out on SPSS-21.0 version. Results: The mean age of all pregnant women was found to be 25.69 ± 3.78 years. With mean Manual Platelet Count (Lacs/cu.mm) 0.83 ± 0.37 lacs/cumm. Out of 158 subjects most common etiology of thrombocytopenia was obstetric causes 70(44.3%) which included 55(34.8%) had hypertensive cause, 8 (5%) subjects had DIC and 7 (4.4%) subjects had abruptio placentae. Out of 55 subjects having hypertensive causes of thrombocytopenia, 43 (27.2%) subjects had preclampsia, 8(5%) had eclampsia and 4(2.53%) subjects had HELLP syndrome etiology of thrombocytopenia of 21 subjects having medical thrombocytopenia, 6(3.79%) subjects had ITP as the cause of thrombocytopenia, 12(7.59%) subjects had dengue, 2(1.26%) subjects had infections like HIV, HCV. There was one subject having hypersplenism as the cause of thrombocytopenia contributing to 0.6 % of the entire causes. No subject had TTP, HUS or TMA as the cause of thrombocytopenia. Second most common cause was gestational thrombocytopenia 67(42.4%). Majority 123(77.8%) of neonates did not have thrombocytopenia at all, 20(12.65%) neonates had mild thrombocytopenia, 12(7.5%) neonates had moderate thrombocytopenia and 3(1.8%) neonates had severe thrombocytopenia. The association between maternal complication and severity of thrombocytopenia PPH, MOD and DIC (p value: 0.005,0.001,0.001 respectively) were significantly associated with thrombocytopenia. The association between perinatal complication with severity preterm birth, LBW, SNCU admission (p-value: 0.002, 0.001, <0.001, respectively) was significantly associated with thrombocytopenia. Conclusion: Our findings suggest that evaluation of thrombocytopenia in pregnancy is important and a detailed workup with careful monitoring is required as early diagnosis and management may play a key role in decreasing the adverse outcomes. Special attention should be given to patients with thrombocytopenia due to preeclampsia and HELLP syndrome to establish the best moment for therapeutical intervention.
Abstract (English)
Background: Thrombocytopenia is defined as a platelet count of less than 150×109/L, or the 2.5th lower percentile of the normal platelet count distribution. Aim of the study was to evaluate the etiological Factors of Thrombocytopenia in pregnancy and its effects on feto-maternal Outcomes. Material and Methods: The prospective observational study was done from September 2020 to October 2021 on one hundred fifty-eight pregnant females with low platelet count or who were diagnosed as thrombocytopenia in second and third trimester at QMH, Department of Obstetrics and Gynaecology, King George’s Medical University, Lucknow. The Chi-square test will be used to compare the categorical variables. The Unpaired t-test was used to compare the continuous variables. The p-value<0.05 was considered significant. All the analysis was carried out on SPSS-21.0 version. Results: The mean age of all pregnant women was found to be 25.69 ± 3.78 years. With mean Manual Platelet Count (Lacs/cu.mm) 0.83 ± 0.37 lacs/cumm. Out of 158 subjects most common etiology of thrombocytopenia was obstetric causes 70(44.3%) which included 55(34.8%) had hypertensive cause, 8 (5%) subjects had DIC and 7 (4.4%) subjects had abruptio placentae. Out of 55 subjects having hypertensive causes of thrombocytopenia, 43 (27.2%) subjects had preclampsia, 8(5%) had eclampsia and 4(2.53%) subjects had HELLP syndrome etiology of thrombocytopenia of 21 subjects having medical thrombocytopenia, 6(3.79%) subjects had ITP as the cause of thrombocytopenia, 12(7.59%) subjects had dengue, 2(1.26%) subjects had infections like HIV, HCV. There was one subject having hypersplenism as the cause of thrombocytopenia contributing to 0.6 % of the entire causes. No subject had TTP, HUS or TMA as the cause of thrombocytopenia. Second most common cause was gestational thrombocytopenia 67(42.4%). Majority 123(77.8%) of neonates did not have thrombocytopenia at all, 20(12.65%) neonates had mild thrombocytopenia, 12(7.5%) neonates had moderate thrombocytopenia and 3(1.8%) neonates had severe thrombocytopenia. The association between maternal complication and severity of thrombocytopenia PPH, MOD and DIC (p value: 0.005,0.001,0.001 respectively) were significantly associated with thrombocytopenia. The association between perinatal complication with severity preterm birth, LBW, SNCU admission (p-value: 0.002, 0.001, <0.001, respectively) was significantly associated with thrombocytopenia. Conclusion: Our findings suggest that evaluation of thrombocytopenia in pregnancy is important and a detailed workup with careful monitoring is required as early diagnosis and management may play a key role in decreasing the adverse outcomes. Special attention should be given to patients with thrombocytopenia due to preeclampsia and HELLP syndrome to establish the best moment for therapeutical intervention.
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IJPCR,Vol15,Issue10,Article13.pdf
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Additional details
Dates
- Accepted
-
2023-09-29
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue10,Article13.pdf
- Development Status
- Active
References
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