Thrombocytopenia is a common finding which occurs in 7-12% of pregnant women. The cause of isolated thrombocytopenia may be differentiated by history, physical examination, laboratory investigation, and medical imaging.
When evaluating a patient for gestational thrombocytopenia (GT), consider the following
GT is the most common cause of thrombocytopenia in pregnancy and accounts for 80% of such cases. GT may be a result of hemodilution and enhanced platelet clearance. The low platelet counts associated with GT are seen during the second and third trimesters with the nadir rarely lower than 70 x 109/L. The diagnosis of GT is made by the presence of a decreased platelet count during pregnancy and should be considered a diagnosis of exclusion. GT usually resolves within days to two months postpartum.
Primary immune thrombocytopenia (ITP) may be difficult to distinguish from GT
Other disorders resulting in non-isolated thrombocytopenia that will present with other related findings include
Thrombocytopenic syndromes in pregnancy
ACOG Practice Bulletin 207: Thrombocytopenia in Pregnancy
Platelet Transfusion: A Clinical Practice Guideline From the AABB
Maternal Fetal Medicine Specialist Locator-SMFM
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