Pregnancy-associated Thrombocytopenia
Kathryn Foucar, MD
Key Facts
Terminology
Reduction in platelet count below normal range that develops during pregnancy
Clinical Issues
Isolated benign gestational thrombocytopenia common in late 3rd trimester in normal gestation
8% of normal pregnancies
> 75% of maternal thrombocytopenias
Immune-mediated thrombocytopenia
May be primary autoimmune or secondary
DIC-like, picture-associated gestational thrombocytopenias
Preeclampsia/eclampsia/HELLP syndrome
Placental abruption/previa
Retained fetus
Amniotic fluid embolism
Postpartum TTP, aHUS
Preeclampsia/eclampsia/HELLP syndrome usually resolves with delivery
 Peripheral blood smear shows thrombocytopenia with normal RBC and WBC parameters. Note normal platelet size and unremarkable RBC morphology characteristic of benign gestational thrombocytopenia. |
 Peripheral blood smear shows marked thrombocytopenia with an enlarged, newly released platelet  compared with a normal-sized platelet  in this example of a platelet survival defect disorder. |
TERMINOLOGY
Definitions
Reduction in platelet count below normal range that develops during pregnancy
CLINICAL ISSUES
Epidemiology
Incidence
Isolated benign gestational thrombocytopenia common in late 3rd trimester in normal gestation
8% of normal pregnancies
> 75% of maternal thrombocytopenias
Normal RBC parameters
No clinical associations
No laboratory evidence of disseminated intravascular coagulation (DIC)
Not linked to clinical consequences in mother or fetus
Immune-mediated thrombocytopenia
3-5% of maternal thrombocytopenias
May be primary autoimmune or secondary
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
