Prevalence and risk factors of thrombocytopenia during the third trimester of pregnancy

Authors

  • Abeer Sami Musaab Maternity Teaching Hospital, Erbil, Iraq.
  • Kamilia Boya Azamat Department of Obstetrics and Gynaecology, College of Medicine, Hawler Medical University, Erbil, Iraq.

DOI:

https://doi.org/10.15218/zjms.2024.011

Keywords:

Thrombocytopenia, Platelets, HELLP syndrome, Preeclampsia

Abstract

Background and objective: Thrombocytopenia, described as a platelet count of less than 150,000 mm3, is a common diagnosis during the period of pregnancy, existing in 7–12% of pregnancies. Mild thrombocytopenia occurs if platelet counts are less than 100,000 mm3, while moderate thrombocytopenia is between 50,000 and 100,000 mm3, and severe thrombocytopenia occurs if platelet counts are less than 50,000 mm3. It could be connected to physiologic changes or pathological diseases; some of them have an impact on pregnancy and may offer a serious risk to both the mother and the unborn child. This study sought to estimate the proportions of the underlying causes as well as the prevalence of thrombocytopenia among pregnant women visiting the antenatal care center in Erbil.

Methods: A cross-sectional study was performed in a maternity teaching hospital in Erbil city, Kurdistan region, Iraq. A convenience sample of 600 pregnant women was used from 28 weeks to 40 weeks of gestation. Over a period of 1 year, starting in January 2021 and ending in December 2021.

Results: The prevalence of thrombocytopenia among the 600 cases was 24.8%, but the majority (75.2%) had a normal platelet count; the degrees of thrombocytopenia were severe in 1.8% of the cases, mild in 8.3%, and moderate in 14.7% of the cases.

Conclusion: A statistically significant association between preeclampsia and HELLP syndrome has been reported as a serious condition that leads to thrombocytopenia. High serum albumin levels in pregnant women related to hypertension had a major impact on the number of platelet counts and should be considered a severe disease.

Metrics

Metrics Loading ...

References

Halici-Ozturk F, Ozturk M, Yakistiran B, CaglarAT, Engin-Ustun Y, Ozgu-Erdinc AS. Severe thrombocytopenia in pregnancy: a retrospective study. Blood Coagul Fibrinolysis 2020; 31(8):517–21. Available from: https://www.ncbi.nlm.nih.gov/pubmed/32897892.

ACOG Publications: August 2022. AJOG Glob Rep 2022; 140(2):347. Available from: https://journals.lww.com/greenjournal/Fulltext/2022/08000/ACOG_Publications__August_2022.35.aspx.

Cines DB, Levine LD. Thrombocytopenia in pregnancy. Blood 2017; 130(21):2271–7. Available from: DOI:10.1182/blood-2017-05-781971.

Al-Husban N, Al-Kuran O. Post-Partum Thrombotic Thrombocytopenic Purpura (TTP) in a Patient with known Idiopathic (Immune) Thrombocytopenic Purpura: J Med Case Rep Rev 2018; 12(1):147. Available from: DOI:10.1186/s13256-018-1692-1.

American College of O, Gynecologists' Committee on Practice B-O. Practice Bulletin No. 166: Thrombocytopenia in Pregnancy. Obstet Gynecol 2016; 128(3):e43–53. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27548554.

Rajasekhar A, Gernsheimer T, Stasi R, James AH. Clinical practice guide on thrombocytopenia in pregnancy. Washington, DC: American Society of Hematology 2013. Available from: https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=Clinical+practice+guide+on+thrombocytopenia+in+pregnancy.+Washington%2C+DC%3A+American+Society+of+Hematology&btnG=.

Loustau V, Debouverie O, Canoui-Poitrine F, Baili L, Khellaf M, Touboul C, et al. Effect of pregnancy on the course of immune thrombocytopenia: a retrospective study of 118 pregnancies in 82 women. Br J Haematol 2014; 166(6):929–35. Available from: https://www.ncbi.nlm.nih.gov/pubmed/24957165.

Orsini S, Noris P, Bury L, Heller PG, Santoro C, Kadir RA, et al. Bleeding risk of surgery and its prevention in patients with inherited platelet disorders. Haematologica 2017; 102(7):1192–203. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28385783.

Xu X, Liang MY, Wang JL, Chen S. Clinical features and outcome of pregnancy with SLE-associated thrombocytopenia. J Matern Fetal Neonatal Med 2016; 29(5):789–94. Available from: https://www.ncbi.nlm.nih.gov/pubmed/25747951.

Romão de Souza V, Beatriz Cavalcante de Oliveira A, Maria Vanderlei A, Queiroz da Mota Silveira Aroucha A, Pontes Duarte B, Nunes Machado A, et al. Inherited thrombotic thrombocytopenic purpura mimicking immune thrombocytopenic purpura during pregnancy: J Med Case Rep 2018; 12(1):1–6. Available from: https://pubmed.ncbi.nlm.nih.gov/29357939/.

van Veen JJ, Nokes TJ, Makris M. The risk of spinal haematoma following neuraxial anaesthesia or lumbar puncture in t hrombocytopenic individuals. Br J Haematol 2010; 148(1):15–25. Available from: https://www.ncbi.nlm.nih.gov/pubmed/19775301.

Michel M, Novoa MV, Bussel JB. Intravenous anti‐D as a treatment for immune thrombocytopenic purpura (ITP) during pregnancy. Br J Haematology 2003; 123(1):142–6. Available from: https://pubmed.ncbi.nlm.nih.gov/14510957/.

Sun D, Shehata N, Ye XY, Gregorovich S, De France B, Arnold DM, et al. Corticosteroids compared with intravenous immunoglobulin for the treatment of immune thrombocytopenia in pregnancy. Blood 2016; 128(10):1329–35. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27402971.

Thalor N, Singh K, Pujani M, Chauhan V, Agarwal C, Ahuja R. A correlation between platelet indices and preeclampsia. Hematol Transfus Cell Ther 2019; 41:129–33. Available from: https://pubmed.ncbi.nlm.nih.gov/31084762/.

AlSheeha MA, Alaboudi RS, Alghasham MA, Iqbal J, Adam I. Platelet count and platelet indices in women with preeclampsia. Vasc Health Risk Manag 2016; 12:477. Available from: https://pubmed.ncbi.nlm.nih.gov/27920548/.

Sultana R, Karim SF, Atia F, Ferdousi S, Ahmed S. Platelet count in preeclampsia. J Dhaka National Med Coll Hos 2012; 18(2):24–6. Available from: https://www.sciencegate.app/document/10.3329/jdnmch.v18i2.16018.

Karateke A, Kurt RK, Baloglu A. Relation of platelet distribution width (PDW) and platelet crit (PCT) to preeclampsia. Ginekol Pol 2015; 86(5):372–5. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26117976.

Han L, Liu X, Li H, Zou J, Yang Z, Han J, et al. Blood coagulation parameters and platelet indices: changes in normal and preeclamptic pregnancies and predictive values for preeclampsia. PLoS One 2014; 9(12):e114488. Available from: https://www.ncbi.nlm.nih.gov/pubmed/25464515.

Sestøl HG, Trangbæk SM, Bussel JB, Frederiksen H. Health-related quality of life in adult primary immune thrombocytopenia. Expert Rev Hematol 2018; 11(12):975–85. Available from: DOI:10.1080/17474086.2018.1548930.

Levy JA, Murphy LD. Thrombocytopenia in pregnancy. J Am Board Fam Pract 2002; 15(4):290–7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/12150462.

Polak F, Kolnikova I, Lips M, Parizek A, Blaha J, Stritesky M. New recommendations for thromboelastography reference ranges for pregnant women.Thromb Res 2011; 128(4):e14–7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21543108.

Gernsheimer T, James AH, Stasi R. How I treat thrombocytopenia in pregnancy. Blood 2013; 121(1):38–47. Available from: https://pubmed.ncbi.nlm.nih.gov/23149846/.

Haram K, Svendsen E, Abildgaard U. The HELLP syndrome: clinical issues and management. A Review. BMC Pregnancy Childbirth 2009; 9(1):8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/19245695.

Talargia F, Getacher L. Thrombocytopenia and Associated Factors Among HIV Infected Patients in Pre- and Post-Anti-Retroviral Therapy, North East Ethiopia. J Blood Med 2021; 12:741–8. Available from: https://pubmed.ncbi.nlm.nih.gov/34429675/.

Downloads

Published

2024-04-24

How to Cite

Musaab, A. S., & Azamat , K. B. . (2024). Prevalence and risk factors of thrombocytopenia during the third trimester of pregnancy . Zanco Journal of Medical Sciences (Zanco J Med Sci), 28(1), 111–118. https://doi.org/10.15218/zjms.2024.011

Issue

Section

Original Articles