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Gestational Thrombocytopenia

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Gestational Thrombocytopenia, Thrombocytopenia in Pregnancy

  • See Also
  1. Thrombocytopenia
  • Epidemiology
  1. Most common cause of Thrombocytopenia in Pregnancy
  2. Incidence: 8-10% of pregnant women
    1. Responsible for 70% of Thrombocytopenia in Pregnancy
  3. Occurs in late pregnancy or early postpartum
  • Pathophysiology
  1. Increased Platelet clearance
  2. Hemodilution
  • Labs
  1. Complete Blood Count
  2. Peripheral Blood Smear
  3. Platelet Count
    1. Mild to moderate isolated Thrombocytopenia (70,000 to 150,000 per mm3)
  • Evaluation
  1. No additional evaluation required if
    1. Platelet Count >112,000 per mm3
    2. No signs of Preeclampsia or HELLP Syndrome
  2. Discuss lower Platelet Counts with hematology or maternal fetal medicine
  3. Obtain Platelet Count in newborns if maternal Immune Thrombocytopenic Purpura is suspected
  • Differential Diagnosis
  1. See Thrombocytopenia
  2. Immune Throbocytopenic Purpura (<0.1% of pregnancies)
    1. Most common in the first and early second trimesters (but may occur in any trimester)
  3. Preeclampsia with HELLP Syndrome
    1. Thrombocytopenia occurs in 20% of Preeclampsia patients
    2. Preeclampsia presents with Hypertension, Proteinuria, edema, Headache, hyperreflexia and visual disturbance
    3. HELLP Syndrome (10-20% of Preeclampsia patients) presents with Hemolytic Anemia, Thrombocytopenia, high LFTs
  • Management
  1. Gestational Thrombocytopenia is typically followed outpatient without intervention required
  2. Evaluate and admit pregnant patients with significant acute Thrombocytopenia
    1. Suggests alternative cause other than Gestational Thrombocytopenia
  • Course
  1. Resolves spontaenously after delivery
  • Prognosis
  1. Benign condition with no associated increased morbidity or mortality in pregnant women or newborns
  • References
  1. Dave, Hoag, Jundoria and Lopez (2026) Crit Dec Emerg Med 40(2): 26-35
  2. Gauer (2012) Am Fam Physician 85(6): 612-22 [PubMed]
  3. Ruggeri (1997) Haematologica 82(3): 341-2 [PubMed]