Is There an Association between Platelet Count and Blood Loss in the Parturient? A Retrospective Study

Area of Science:

• Obstetrics and Gynecology
• Hematology

Background:

• Postpartum hemorrhage (PPH) remains a leading cause of maternal morbidity and mortality.
• The impact of thrombocytopenia (low platelet count) on obstetric blood loss has been inconsistently reported.

Purpose of the Study:

• To investigate the association between predelivery platelet count and quantitative blood loss (QBL) and PPH.
• To analyze these associations separately for vaginal delivery (VD) and cesarean delivery (CD).

Main Methods:

• Retrospective analysis of 22,479 delivery records (April 2017 - September 2020).
• Assessment of platelet count closest to delivery and QBL.
• Stratification of patients based on platelet count, including those with thrombocytopenia (<150,000/mm³).

Main Results:

• Thrombocytopenia was present in 12% of patients (2,600/22,479).
• Patients with thrombocytopenia had significantly higher QBL (median difference: 25 mL for VD, 57 mL for CD).
• A statistically significant association was found between lower platelet counts and increased QBL and PPH incidence, though the magnitude of blood loss difference was small.

Conclusions:

• Lower predelivery platelet counts are statistically linked to increased QBL and PPH.
• The clinical relevance of this association is uncertain due to the small observed differences in blood loss across platelet count ranges.