jsmc-10138

THE INCIDENCE OF THROMBOCYTOPENIA AMONG 600 PREGNANT LADIES IN SULAIMANI-IRAQ   

Nzar Hussein Hassan a, Awaz Ahmed Kamal Shalli b, Sana Dlawar Jalal b,  and Azad Rasheed Mustafa d

a Sulaimani Blood Bank.

b Department of Pathology, College of Medicine, University of Sulaimani. 

d Shar Teaching Hospital. 

Submitted: 27/3/ 2017; accepted: 17/8/ 2017; Published 21/12/2017 

DOI Link: https://doi.org/10.17656/jsmc.10138

ABSTRACT

Background 

Thrombocytopenia in pregnancy is quite common; it’s the second most common hematological abnormality, after anemia, during pregnancy. Thrombocytopenia results from a wide range of conditions, several of them being pregnancy related. While some of these are not associated with adverse pregnancy outcomes, others are associated with substantial maternal and /or neonatal morbidity and mortality.

Objective

To determine the incidence and various underlying causes of thrombocytopenia in pregnant women in Sulaimani-Iraq.

Methods

In this study a total of 600 pregnant women at different gestational ages, and 150 non- pregnant apparently healthy women, as control, were included. They were randomly selected from different primary health care centers and outpatient clinics of Maternity Teaching Hospital in Sulaimani city. Full history, physical examination and laboratory investigations were performed.

Results

The incidence of thrombocytopenia in the pregnant group was 7.7 % with gestational thrombocytopenia accounting for 76.1% of cases, followed by pregnancy induced hypertensive disorders in 19.6% of cases. The platelets count in pregnant women included in the study ranged from 60-450 x 109 /L with a mean of (250.2 x 109 /L ± 68.39), a value that is significantly lower than the value in control group with a range of platelets from 162-392 x 109 /L, and a mean of (285 x 109 /L ± 48.2) (P value= 0.001). 

Conclusion

Gestational thrombocytopenia is the commonest cause (76.1% of cases) for thrombocytopenia occurring later in pregnancy in this study, and a platelets count ≥ 121 x 109/L detected late in pregnancy does not require sophisticated investigations and should be regarded as safe threshold.

KEYWORDS

Thrombocytopenia, Pregnancy, Gestational thrombocytopenia, Sulaimani.

References 

1. Elmukhtar H, Amnna R, Ramadan G. Thrombocytopenia in hypertensive disease of pregnancy . J Obstet Gynecol India 2013:63(2):96-100.

2. Jffrey A Levey, Lance D. Murpby. Thrombocytopenia in pregnancy. J Am Board Fam Pract 2002:15:290-7.

3. Anca M C , Simona C A,  Maria P. Thrombocytopenia in pregnancy. Maedica(Buchar) 2016:11(1): 55-60.

4. Antica D N. Thrombocytopenia in pregnancy.UDK 2015 616.155.2:618.

5.Yazdani S, Bouzari Z, Sedaghat S, Abedi SM, Farajnezhad K. Incidence of thrombocytopenia and associated factors. Journal of Mazandaran university od medical science 2012; 22(89):58-64.

6. Usha P, Lori R. Maternal thrombocytopenia in pregnancy. Proceedings in obstetrics and Gynecology 2013;3(1):6.

7. Bergmann F, Rath W. The differential diagnosis of thrombocytopenia in pregnancy. Dtch Arztebl Int 2015;112(47):795-802.

8. Bethan M. Diagnosis and management of maternal thrombocytopenia in pregnancy. Bjh 2012;589(1):3-15.

9. Win N, Rowley M, Pollard C, Beard J, Hambley H, Booker M. Severe gestational(incidental) thrombocytopenia: to treat or not to treat. Hematology 2005;10(1):69-72.

10. Gill K K, and Kelton J G. Management of idiopathic thrombocytopenic purpura in pregnancy. Seminars in Haematology 2000;37:275-289.

11. Fridi A, Rath W. Differential diagnosis of thrombocytopenia in pregnancy. Zentralblatt fur Gynakologie 2001;123(2): 80-90.

12. Terry G, Andra H J and Roberto S. How I treat thrombocytopenia in pregnancy. Blood 2013;121:38-47. 

13. Vesna E G, Petrana B, Snjezana G A, Snjezana S, Snjezana S. Fetal-Maternal complications and their association with gestational thrombocytopenia. Ginekologia Polska 2016;87(6):454-459.

14. Gari- Bai AR. Thrombocytopenia during pregnancy. Annals of Saudi Medicine 1998;18:2.

15. Asmaa M Thanoon, Sana D J. Thrombocytopenia in Iraqi pregnant women. Fac Med Baghdad.2011;53(2).

16. Shamoon RA, Muhammed NS, Jaff MS. Prevalence and etiological classification of thrombocytopenia among a group of pregnant women in Erbil City. Iraq.Turk J Hematol. 2009;26:123-8.

17. Burrows RF, Kelton JG. Thrombocytopenia at delivery ( a prospective survey of 6715 deliveries). Am J Obstet Gynecol.1990; 162: 731-734.

18. Sainio S, Kekomaki R, Rikonen S, Teramo K. Maternal thrombocytopenia at term: a population based study. Acta Obstet Gynecol Scand. 2000; 79(9): 744-749.

19. Ruggeri M, Schiavotto C, Castaman G, Tosetto A, Rodeghiero F. Gestational thrombocytopenia: A prospective study. Hematologica 1997;82(3):341-2.

20. Lescale KB, Eddlemen KA, Cines DB, et al. Anti platelet Ab testing in thrombocytopenic pregnant women. Am J. Obstet Gynecol 1996;174(3):1014-18

21. Rubina N, Mohammad AK, Taslemm A, Nabila S, Hina A, Jamila Haider. Frequency of thrombocytopenia in pregnancy related hypertensive disorders in patients presenting at tertiary care hospitals of Peshawar. Khyber Med Univ J 2012;4(3);101-105.

22 Burrows RF, Andrew M. Neonatal thrombocytopenia in the hypertensive disorders of pregnancy. Obstet Gynecol 1990;76:234-238.

23. Bohlen F, Hohlfeld P, Extermann P et al. Platelet count at term pregnancy: a reciprocal of the threshold. Obstet Gynecol 2000;95:29-33.

24.George JN.Thrombocytopenia in pregnancy. N Eng J Med 1998;583:14

25. Lain KY, Roberts JM. Contemporary concepts of the pathologenesis and management of preeclampsia. J Am Med Assoc 2002;287:31

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