Quantitative and qualitative platelet abnormalities during pregnancy

Area of Science:

• Obstetrics and Gynecology
• Hematology

Background:

• Thrombocytopenia, or low platelet count, can occur during pregnancy.
• The incidence and implications of mild, transient thrombocytopenia require further investigation.

Purpose of the Study:

• To prospectively evaluate mild, transient thrombocytopenia in pregnant women.
• To determine the need for extensive testing in such cases.

Main Methods:

• Prospective follow-up of 15 pregnant women with newly diagnosed thrombocytopenia.
• Platelet count, von Willebrand factor antigen, ristocetin cofactor activity, bleeding times, and platelet antibodies were assessed.
• Neonatal platelet counts were also monitored.

Main Results:

• Platelet counts normalized in 14 of 15 patients within 4-6 weeks postpartum.
• Three patients were diagnosed with mild type I von Willebrand disease.
• Six patients had detectable platelet antibodies.
• One neonate had thrombocytopenia.

Conclusions:

• Mild, transient, isolated thrombocytopenia is a possible finding in normal pregnancy.
• Extensive laboratory testing is generally not indicated unless a prolonged bleeding time is present.
• Consider von Willebrand disease or qualitative platelet disorders in cases with bleeding abnormalities.