Thrombocytopenia in pregnancy

Thrombocytopenia in pregnancy – definition

Thrombocytopenia is an insufficient number of platelets, or thrombocytes. Their main task in the body is blood clotting. If platelets are insufficient, clotting disorders in the form of excessive bleeding, for example, may appear.

Thrombocytopenia is detected during routine blood counts, performed once every four weeks on every pregnant woman. It is considered that with a platelet count of less than 150,000, thrombocytopenia is diagnosed. It is important to perform diagnostic tests and find its cause.

Thrombocytopenia in pregnancy – causes

Most often, thrombocytopenia in pregnancy is associated with increased plasma volume and is referred to as gestational thrombocytopenia. It is usually not associated with serious complications or the risk of perinatal hemorrhage. Thrombocytopenia in pregnancy is also a symptom of pre-eclampsia and HELLP syndrome. Then it is often accompanied by hypertension or elevated liver parameters. Thrombocytopenia can also occur in the course of intravascular coagulation (DIC) and von Willenbrandt disease.

Thrombocytopenia in pregnancy – management

The basic principle when diagnosing thrombocytopenia during pregnancy is to try to determine its cause. The doctor will interview the pregnant woman about possible symptoms and previous platelet problems. In addition, diagnostics for viral hepatitis or cytomegalovirus are performed, as well as a manual blood smear. It is also worth performing a blood draw “for citrate”, which will help rule out pseudo thrombocytopenia. If pre-eclampsia is suspected, the mother-to-be should have her blood pressure measured regularly and have tests such as creatinine, ALT or AST levels and a general urine test for proteinuria.

Thrombocytopenia in pregnancy – childbirth

Determining the route of delivery depends on the individual obstetric situation. Thrombocytopenia alone is not an indication for cesarean section. However, if it is a symptom of HELLP syndrome – urgent termination of pregnancy is essential. Platelet counts are particularly important for anesthesiologists during labor. Values below 70-80,000 are considered a contraindication to subarachnoid or epidural anesthesia. However, the decision regarding anesthesia is always made individually by the anesthesiologist.

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