Clinical relevance of gestational thrombocytopenia of <100,000/μl

Eyal Anteby, Oded Shalev

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

We identified 22 women with thrombocytopenia of <100,000/μl found incidentally during pregnancy and prospectively monitored their platelet count and clinical outcome for a minimum of 6 months postpartum. During the study period, four women became pregnant twice, accounting for a total of 26 pregnancies. The lowest platelet count during pregnancy was 65,600/μl ± 19,400 (mean ± SD), and at delivery 84,500/μl ± 32,300 (P < 0.02). The thrombocytopenia was virtually asymptomatic in all patients during the pregnancy and delivery, whether vaginal or surgical. Neonatal platelet counts (n = 18) were normal (270,700/μl ± 69,900), and none of the newborns (n = 24) had a bleeding diathesis. Normalization of the platelet count (i.e., >150,000/μl) was documented in 18 patients within 1 month postpartum, in five within 3 months postpartum, and in two as late as 5 months after delivery. One woman did not recover from the thrombocytopenia and eventually developed other stigmata of an autoimmune disease. Long‐term follow‐up showed recurrence of thrombocytopenia in four patients: three in the context of a subsequent pregnancy and one who developed idiopathic thrombocytopenic purpura. Retrospective analysis of blood counts obtained from 12 previous pregnancies demonstrated thrombocytopenia of a similar degree to the index pregnancy. We conclude that gestational thrombocytopenia of <100,000/μl is clinically a benign phenomenon that can recur in subsequent pregnancies and is not accompanied by neonatal thrombocytopenia. In some cases, however, pregnancy‐associated thrombocytopenia may be a manifestation of an autoimmune disease with its attendant implications for the neonate. Since the differential diagnosis between the two conditions may be difficult to establish when first encountered during pregnancy, a conservative approach emphasizing careful surveillance and guarded reassurance is justified as long as the platelet counts are >50,000/μl. © 1994 Wiley‐Liss, Inc.

Original languageEnglish
Pages (from-to)118-122
Number of pages5
JournalAmerican Journal of Hematology
Volume47
Issue number2
DOIs
StatePublished - 1 Jan 1994
Externally publishedYes

Keywords

  • gestation
  • neonate
  • pregnancy
  • thrombocytopenia

ASJC Scopus subject areas

  • Hematology

Fingerprint

Dive into the research topics of 'Clinical relevance of gestational thrombocytopenia of <100,000/μl'. Together they form a unique fingerprint.

Cite this