[Managing a pregnant woman with a low platelet count]

The practical management of a pregnant woman with a platelet count below 150 x 10(9) per liter is very simple.

A spurious thrombocytopenia must be discarded and isolated thrombocytopenia (begnin idiopathic gestational thrombocytopenia and idiopathic thrombocytopenic purpura) must be first differenciated from associated forms. It must be determined if thrombocytopenia appeared recently and therefore is directly specific of pregnancy. Severity is indicated by a very low platelet count and a high speed in lowering. Platelet count of the newborn must always be checked on ombilical cord blood at the time of the birth. Steroid therapy may be needed in some cases of idiopathic thrombocytopenic purpura, lupus or HELLP syndrome. Platelet counts must be checked, in every case, three months after delivery and in case of subsequent pregnancy.

Low platelet count is a demonstrative example of the help the internist can afford to the obstetrician in the management of pregnancy-associated conditions.