PROSPECTIVE STUDY OF THROMBOCYTOPENIA IN PREGNANCY AND ITS MATERNAL AND NEONATAL OUTCOME

Abstract

Introduction: Thrombocytopenia is the most frequent hematological condition observed during pregnancy. Evidence has shown foetus and maternal outcomes of thrombocytopenia during pregnancy that aren't good. This study aimed to find the causes and maternal, neonatal outcomes in pregnant with thrombocytopenia. Materials and methods: The present study is a prospective observational study that included antenatal cases with gestational age more than or equal to 28 weeks with low platelet count. Pregnant women with ages between completed 18-40 are included. Patients included in the study followed up by estimation of platelet count till 5th postpartum day. Outcomes including mode of delivery, gestational age at the time of delivery, the need of blood and blood components transfusion, ICU admissions, neonatal thrombocytopenia were documented. Pvalue < 0.05 will be considered statistically significant. Results: A total of 95 subjects were analyzed. The majority of the subjects were in the age group of 21-25 years, followed by 26-30years. In the present study shows the majority of them had mild thrombocytopenia. Among the study participants, the most common aeitology was gestational thrombocytopenia followed pre-eclampsia – eclampsia. 27.37% required blood and blood products transfusion. The majority of the neonates had a healthy birth weight of 2.50 to 3.49kg in 54.74%. The maternal complication recorded in the present study is Postpartum Hemorrhage in 9.47%, abruption in 5.2%, ICU Admission for 2.11%, and DIC in 2.11% of participants. 2.11% of the neonates found to have neonatal thrombocytopenia. There was a statistically significant difference was observed in maternal thrombocytopenia between transfusion (P-Value >0.05). xix Conclusion: In the present study the most common cause of thrombocytopenia in pregnancy is gestational thrombocytopenia followed by less common causes were preeclampsia, HELLP Syndrome ,anemia, COVID -19, dengue fever and megaloblastic anemia . Pre eclampsia and HELLP syndrome were associated with post partum hemorrhage with abruptio placenta, DIC, need of transfusion of blood and blood products, ICU admission and intrauterine death in this study . It is crucial to evaluate thrombocytopenia in pregnancy to distinguish between gestational thrombocytopenia and other serious conditions like pre eclampsia, HELLP syndrome, ITP, infections which have the potential for serious morbidity and mortality. Management of pregnant women with thrombocytopenia requires a multidisciplinary approach and with close collaboration between obstetrician and hematologist required to reduce the maternal and fetal mortality and morbidity.