PMM.25 Outcomes in women with thrombocytopenia in pregnancy

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Abstract

Background

Antenatal thrombocytopenia occurs in 5% of pregnancies and is predominantly due to gestational thrombocytopenia (GTP), or more rarely is immunologically-mediated (ITP). The risk of significant neonatal thrombocytopenia (<50 × 109/L) has been suggested as 5–10% in women with ITP, although risk of bleeding is low. The aim of this study was to report pregnancy outcomes of women with thrombocytopenia in a large UK tertiary referral centre.

Methods

Pregnant women with platelet counts ≤ 120 × 109/L were identified retrospectively from the laboratory records between December 2011 and December 2012. Pregnancy and neonatal records were examined and data collected.

Results

Laboratory records identified 215 women with a platelet count ≤ 120 × 109/L during pregnancy. 118/215 (55%) were excluded due to pre-eclampsia, sepsis or post-partum haemorrhage. 100 infants were born to 97 women, 25 (26%) delivered by Caesarean section. 17 had presumed GTP, 30 ITP, with 50 being of unknown cause antenatally. 10/98 (10.2%) had a blood loss greater than 1000mls, comparable to the hospital population (9.2%). Neonatal platelet counts were available 69/101(68%) babies. 19/69 (27.5%) had thrombocytopenia <150 × 109/L, with 3 (4.3%) <50 × 109/L. There was one report of a small non-significant intraventricular haemorrhage (platelets 12 × 109/L). Maternal platelet count did not correlate with either blood loss or neonatal platelet count.

Conclusions

Whilst neonatal thrombocytopenia was relatively common (27.5%), clinically significant neonatal thrombocytopenia was rare which is reassuring for women. Low maternal platelets did not increase the risk of postpartum haemorrhage.

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