شیوع ترومبوسیتوپنی در بارداری و عوامل مرتبط با آن

Background and purpose: After anemia thrombocytopenia is the most common disorder in pregnancy which is encountered in 10% of pregnancies. Thrombocytopenia in pregnant women may lead to maternal and neonatal morbidity. This condition could involve some complications in pregnancy, so diagnosing its causes is important for treatment. This study was performed to determine the incidence, causes and complications of thrombocytopenia in pregnancy. Materials and methods: In this prospective study, all pregnant women with gestational age of ≥ 24weeks and also those in pregnancy termination stage who referred to two teaching hospitals in Babol, during 2008-2009 were selected. Among this population those with platelet count less than 150,000/ µL were chosen. Causes of thrombocytopenia, method of delivery, maternal and neonatal complications in these patients were recorded. Platelet count less than 100,000/ µL was considered severe thrombocytopenia. Results: During the study period, 4589 pregnant women were examined and thrombocytopenia was reported in 239 cases. The incidence of thrombocytopenia in pregnancy was 5.2%. The causes of thrombocytopenia were gestational thrombocytopenia in 222 patients (92.9%), ITP in 11 patients (4.6%), preeclampsia in five patients (2.1%) and HELLP syndrome in one patient (0.4%). Six pregnancies (2.5 %) resulted in IUFD and bleeding occurred only in one patient with ITP during and after delivery. No neonatal complication was seen in newborns of women with thrombocytopenia. Conclusion: The results showed that gestational thrombocytopenia was the most common cause of thrombocytopenia in pregnancy which revealed no complication for patients and their fetuses. However, differential diagnosis should be made to avoid diagnosis of HELLP syndrome or preeclampsia that require urgent termination of pregnancy to prevent further complications.