Abstract:
Objective: To determine the etiology, and outcome of thrombocytopenia in pregnancy. Study design, settings and duration: An Observational hospital based study was conducted at Isra University hospital Hyderabad for three years from 1st January 2009 to 31st December 2011. Patients and Methods: Total 3576 obstetric patients were admitted in Obstetrics & Gynecology department during this period of whom 71(1.9%) had thrombocytopenia in pregnancy. Depending on the number of platelets; thrombocytopenia was divided into four groups, i.e. those having platelets below 20,000, between 20-50,000, between 50-100,000 and more than 100,000. Patients with chronic liver disease and drug induced thrombocytopenia were excluded from the study. A predesigned structured proforma was used. All results were analyzed on statistical software SPSS version 16 Frequencies and percentages were calculated, the final outcome was recorded Results: The most common cause of thrombocytopenia was gestational thrombocytopenia seen in 24(33.8%) patients followed by HELLP syndrome19 (26.7%) and hepatitis E in 10(16.3%) patients. There were 11 cases who had platelets below 20,000, 18 had levels between 20-50,000 and 19 had between 50-100,000. The common symptoms were bleeding seen in 30(42.2%) cases and purpura or easy bruising seen in 11(15.4%) cases while, 30 cases were asymptomatic. Of 11 cases that had platelets below 20,000, 10 mothers died along with their 7 babies while, only 3 surviving babies were those of mothers dying of post partum hemorrhage. Eighteen mothers had platelets between 20-50,000 and out of these 9 mothers and 11 neonates died. Nineteen mothers had platelets between 50-100,000 and out of these one mother and 3 neonates died. Overall maternal mortality was 20(28.1%). Maternal and fetal deaths occurred in almost all cases with DIC, HEV and malaria while, in PPH mothers died but their newborns survived irrespective of platelet count. Conclusion: Diseases causing platelets below 50,000 in pregnancy should be rated as high risk pregnancies and dealt with accordingly to reduce high fetal or maternal mortality.
Page(s):
67-70
DOI:
DOI not available
Published:
Journal: Pakistan Journal of Medical Research, Volume: 52, Issue: 3, Year: 2013