Moderate to Severe Thrombocytopenia During Pregnancy: A Single Institutional Experience

Most of thrombocytopenic pregnant women present mild decrease of platelet counts and have favorable outcome. However, small portion of these cases can show moderate to severe thrombocytopenia and may increase the risk of bleeding during delivery. We investigated the prevalence, causes, and outcomes of pregnancies complicated by moderate to severe thrombocytopenia. We reviewed medical records of pregnant women who were diagnosed with moderate to severe thrombocytopenia (<100 × 10⁹/L) during their pregnancies. A total of 4822 deliveries were performed and 26 patients (0.54%) with moderate to severe thrombocytopenia were identified. The most common cause of moderate to severe thrombocytopenia was immune thrombocytopenia (ITP) (42.3%), followed by gestational thrombocytopenia (GT) (34.6%). Compared to GT, ITP showed lower platelet counts at presentation (52.4 × 10⁹/L vs. 80.5 × 10⁹/L, P = 0.041). Patients with GT could conduct successful delivery without specific management, and patients with ITP showed favorable delivery outcomes with adequate treatment. In conclusion, the incidence of moderate to severe thrombocytopenia during pregnancy was very low and most common causes were ITP and GT. Patients with moderate to severe thrombocytopenia could have favorable delivery outcomes with adequate treatment.