Thrombocytopenia in Pregnancy: Frequency and Outcome

Abstract

Background: Thrombocytopenia is the second most common hematologic disorder during pregnancy, with significant maternal and neonatal implications if not managed appropriately. Objective: To determine the frequency, etiological factors, and maternal–perinatal outcomes of thrombocytopenia in pregnant women at a tertiary care hospital. Methods: A prospective observational study was conducted from January to December at the Department of Obstetrics and Gynaecology, Central Park Teaching Hospital. Pregnant women diagnosed with thrombocytopenia (platelet count <150,000/µL) were enrolled and monitored until delivery. Investigations were performed to determine the cause and severity. Maternal and neonatal outcomes were recorded and analyzed. Results: Among 1,916 deliveries, 41 women (2.14%) had thrombocytopenia. The majority presented in late pregnancy (33–40 weeks). Gestational thrombocytopenia was the most common cause (56.1%), followed by immune thrombocytopenic purpura (17.1%). Mild thrombocytopenia was observed in 58.5%, moderate in 31.7%, and severe in 9.8%. Most women had no maternal morbidity (95.1%), while perinatal outcomes were favorable in 75.6% of cases. Complications included prematurity (14.6%), fetal growth restriction (7.3%), and stillbirth (2.4%). Conclusion: Gestational thrombocytopenia is the predominant cause and is generally benign. However, hypertensive and autoimmune disorders can lead to adverse outcomes. Early diagnosis and multidisciplinary management are vital to reducing maternal and neonatal complications.