GESTATIONAL THROMBOCYTOPENIA: MATERNAL AND FETAL OUTCOMES IN DUHOK

Background: Thrombocytopenia (platelet counts less than 150 X109/ L), is a common hematological finding during pregnancy ranking secondly after anemia. This study aimed to examine possible contributing factors to the low platelet count in pregnant women with thrombocytopenia during their intrapartum period and the maternal and fetal outcomes. Patients and Methods: A total of 33,476 women with a singleton pregnancy with a gestational age of 28 weeks and beyond were admitted to the labor ward at Duhok obstetrics and gynecology hospital between May 2015 and January 2018. Applying the hospital routine admission protocol, the platelet count of each of them was estimated and a total of 802 thrombocytopenic cases were selected. All patients denied any previous related medical or obstetric histories: like hypertensive diseases of pregnancy, connective tissue disorders, immune thrombocytopenia, liver or renal disease, and drug-induced thrombocytopenia. Maternal and fetal outcomes were assessed to see if there are any risks of this incidental finding on their health. Results: The study found that most of the patients did not needed blood or platelet transfusions, 759 (94.6%), and 788 (98.3%), respectively. None of them developed any reaction to the blood transfusions. The platelet account did not affect the mode of delivery since most of them had vaginal deliveries 572 (71 %). However, 230 ( 29%) of them needed a cesarean section; the reason was mainly due to obstetrical causes (failure of progress of labor, fetal distress, oligohydramnios, breech presentation, and more than one previous scar presented in labor). Most of the patients with a significant low platelet count (≤ 50 X109/L) had their newborns admitted to Neonatal Intensive Care Unit (NICU), those who received more blood or platelet transfusions had significantly lower platelet count and lower birth weights. Conclusions: This study showed that women with markedly reduced platelet counts are more at risk, and the demand for blood and blood product transfusions is much increased, and they mostly gave birth to low birth weight babies. Duhok Med J 2020; 14 (2): 86-96