Clinical Profile and Maternal–Neonatal Outcomes of Thrombocytopenia in Pregnancy: A Prospective Observational Study

Author(s): Vidhi Singh, Priyanka kanwaria, Ayushi Aggrawal

Background: Thrombocytopenia is a common hematological abnormality encountered during pregnancy and may range from a benign physiological finding to a manifestation of severe maternal disease with significant fetomaternal implications.

Objectives: To evaluate the clinical profile, etiological spectrum, severity, and associated maternal and neonatal outcomes of thrombocytopenia in pregnancy. Methods: This prospective observational study was conducted over 24 months at a tertiary care center and included 350 pregnant women with platelet counts <150 × 10?/L. Maternal demographics, severity and etiology of thrombocytopenia, and maternal and neonatal outcomes were analyzed.

Results: Mild thrombocytopenia was observed in 61.1% of women, moderate in 29.1%, and severe in 9.8%. Gestational thrombocytopenia was the most common etiology (60%), followed by hypertensive disorders of pregnancy (21.1%) and immune thrombocytopenic purpura (10.9%). Postpartum hemorrhage occurred in 14.9% of cases, and 19.4% required platelet transfusion. Severe thrombocytopenia was significantly associated with increased rates of postpartum hemorrhage, intensive care unit admission, and transfusion (p < 0.001). Adverse neonatal outcomes included preterm birth (24%), low birth weight (33.7%), neonatal intensive care unit admission (20.6%), neonatal thrombocytopenia (8%), and perinatal mortality (4%).

Conclusion: Thrombocytopenia in pregnancy is a heterogeneous condition. While mild gestational thrombocytopenia is largely benign, moderate to severe thrombocytopenia—particularly when associated with hypertensive disorders or immune thrombocytopenic purpura—is associated with significant maternal and neonatal morbidity.