2110 Viewed1061 Downloaded
Maternal-Fetal Outcomes of Pregnancies with Thrombocytopenia-One Center Experience
Received: 14 Jun 2019 | Received in revised form: 08 Jul 2019
Accepted: 01 Oct 2019 | Available online: 22 Oct 2019Cem YENERa,b, Sinan ATEŞa, Cenk SAYINa,b, Havva SÜTCÜa,b, Füsun VAROLa,b
aDepartment of Obstetrics and Gynecology,
bDivision of Perinatology,
Trakya University Faculty of Medicine, Edirne, TURKEY
J Clin Obstet Gynecol. 2019;29(3):94-9
DOI: 10.5336/jcog.2019-70169
Article Language: EN
Copyright Ⓒ 2024 by Türkiye Klinikleri. This is an open access article under the CC BY-NC-ND license (
http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: To investigate the etiology, obstetric risk factors, complications, and outcomes of pregnancies affected by thrombocytopenia. Material and Methods: A retrospective surveillance study was conducted based on the hospital records of 1286 women that gave birth during the period between 1st January 2017 and 31st December 2018 at the Department of Gynecology and Obstetrics of the Trakya University's School of Medicine. Clinical data including basic history, physical examination, and investigations of women with thrombocytopenia were evaluated. We randomly selected 154 patients without thrombocytopenia that delivered in our clinic during the same period, as the control group, and compared the maternal and fetal outcomes with the thrombocytopenic patient group. Results: A total of 154 out of 1286 women (11.9%) had thrombocytopenia of varying severity. Gestational thrombocytopenia (GT) was the most common cause, being identified in 76.2% of the cases with thrombocytopenia. This was followed by preeclampsia (15.5%). About 4.5% of pregnant women with thrombocytopenia were accounted for by idiopathic thrombocytopenic purpura (ITP), 2.5% of the patients by eclampsia, while HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome was observed in 1.3% of the pregnant women with thrombocytopenia. An increased rate of IUGR (Intrauterine growth restriction), fetal distress, and adverse neonatal outcomes were recorded among patients that had thrombocytopenia with preeclampsia, eclampsia, and HELLP syndrome. Furthermore, we observed higher rates of fetal distress and adverse neonatal outcomes in patients with thrombocytopenia compared to the control group. Conclusion: GT was the most common cause of thrombocytopenia in pregnancy, followed by preeclampsia. Eclampsia, HELLP syndrome, and ITP were rare causes of this disorder during pregnancy. Early detection and treatment of expected complications are critical for the effective management of such cases.
REFERENCES:- McCrae KR. Gebelikte trombositopeni. Hematoloji Am Hematol Eğitim Programı. 2010; 2010: 397-402. [Crossref] [PubMed]
- İzkalemkaem F. [Trombositopeni ve gebelik]. Türkiye Klinikleri J Hematol-Özel Konular. 2014, 7 (2): 88-98.
- Parnas M, Sheiner E, Shoham-Vardi I, Burstein E, Yermiahu T, Levi I, vd. Gebelikte orta ila şiddetli trombositopeni. Eur J Obstet Gynecol Reprod Biol. 2006; (1-2) 128: 163-8. [Crossref] [PubMed]
- Yüce T, Seval M, Acar D, Atabekoğlu C. Gebelikte trombositopeni: evans sendromu konvansiyonel olmayan tanı, gebelikte evans sendromu: olgu sunumu. Türkiye Klinikleri J Gynecol Obst. 2016, 26 (1): 52-5. [Crossref]
- Wang X, Xu Y, Luo W, Feng H, Luo Y, Wang Y ve diğerleri. Gebelikte farklı tanılara sahip trombositopeni: ayırıcı klinik özellikler, tedaviler ve sonuçlar. Tıp (Baltimore). 2017; 96 (29): e7561. [Crossref] [PubMed] [PMC]
- Stavrou E, McCrae KR. Gebelikte immün trombositopeni. Hematol Oncol Clinic Kuzey Am. 2009; 23 (6): 1299-316. [Crossref] [PubMed] [PMC]
- Gezgin T, Soysal ME, Soysal S. Gebelikte idiyopatik trombositopenik purpura: Bir olgu sunumu. Türkiye Klinikleri J Gynecol Obst. 2003, 13 (4): 319-21.
- Bussel JB, Druzin ML, Cines DB, Samuels P. Gebelikte trombositopeni. Lancet. 1991; (8735) 337: 251. [Crossref]
- Burrows RF, Kelton JG. Teslimatta trombositopeni: 6.715 teslimatlı prospektif bir anket. Ben J Obstet Gynaecol. 1990; 162 (3): 731-4. [Crossref]
- Aziz S, Kekom R, Riikonen S, Teramo K. Dönemin maternal trombositopeni: Populasyon temelli bir çalışma. Açta Obstetr Gynecol Scand. 2000, 79 (9): 744-9. [Crossref] [PubMed]
- Gümüş R, Berkowitz R, Bussel J. Gebelikte trombositopeni. Uygulama Bülteni, Sayı 6. Chicago. Clin Obstet ve Gynaecol. 1999; 42: 335-48. [Crossref] [PubMed]
- Kwon JY, Shin JC, Lee JW, Lee JK, Kim SP, Rha JG. Trombositopeni ile başvuran gebe kadınlarda idiyopatik trombositopenik purpura belirleyicileri. Int J Gynaecol Obstet. 2007, 96 (2): 85-8. [Crossref] [PubMed]
- Belkin A, Levy A, Sheiner E. İmmün trombositopenik purpuralı kadınlarda perinatal sonuçlar ve gebeliğin komplikasyonları. J Matern Fetal Neonatal Med. 2009; (11) 22: 1081-5. [Crossref] [PubMed]
- Ciobanu AM, Colibaba S, Cimpoca B, Peltecu G, Panaitescu AM. Gebelikte trombositopeni. Maedica (Buchar). 2016; 11 (1): 55-60.
- Shehata N, Burrows R, Kelton JG. Gebelik trombositopeni. Clin Obstet Gynecol. 1999; 42 (2): 327-34. [Crossref] [PubMed]
- Saxena N, Bava AM, Nandanwar Y. Ağır preeklampsi ve eklampside maternal ve perinatal sonuç. Int J Reprod Kontraseptif Doğum Jinekol. 2016, 5 (7): 2171-6.[Crossref]
- Onis M, Vla da reanu AM, Delcea C, Ciora scu M, Bumbea H, Nicolescu A, vd. Trombositopeni ile komplike olmuş gebeliklerde perinatal sonuç. J Matern Fetal Neonatal Med. 2012; 25 (9): 1622-6. [Crossref] [PubMed]