Thrombocytopenia in pregnancy

Defined as a platelet count below 150,000 platelets/ml.

Counts between 150,000-100,000, 100,000 and 50,000 and below 50,000 considered mild, moderate and severe, respectively.

Birth relatively safe with platelet counts between 30-50,000/mL.

Cesarean section can be performed in a safe fashion with platelet counts of 50-70,000, and the cutoff level in the U.S. considered safe at 70,000.

Vaginal birth safer than cesarean and platelet cont is pref2242ed to be above 50,000 platelets/mL and higher is epidural anesthesia is required.

Present in 10-15% of pregnant women.

60-80% have gestational thrombocytopenia, 10-15% have immune thrombocytopenic purpura and 20% have eclampsia or HELLP syndrome and the remainder have rare causes such as thrombotic thrombocytopenic purpura, DIC antiphospholipid syndrome and acute fatty liver of pregnancy.

Gestational thrombocytopenia defined associated mild to moderate thrombocytopenia which is rarely less than 70,000 platelets/mL.

Gestational thrombocytopenia may be secondary to increased clearance of platelets or hemodilution and generally appears in the third trimester.

Gestational thrombocytopenia does not progress, presents no danger to mother or fetus and usually resolves within 12 weeks after delivery.

Gestational thrombocytopenia can recur with subsequent pregnancies.

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