[Thrombocytopenia and pregnancy : a practical approach]

Thrombocytopenia affects approximately 10% of pregnancies. It is most often benign (gestational thrombocytopenia), but some causes, particularly immune thrombocytopenia or preeclampsia, require specific management. The diagnostic approach and practical management depend on the medical history, background, gestational age, and severity of thrombocytopenia. A targeted work-up helps exclude serious causes, especially preeclampsia and other microangiopathies, that constitute a clinical emergency. Treatment, only required for severe or symptomatic thrombocytopenia, is tailored on the underlying etiology. This article proposes a practical, evidence-based approach, informed by current guidelines and experience at the CHUV, to guide the primary care physician.