Saturday, May 19, 2018

Gestational Thrombocytopenia

Q: Gestational thrombocytopenia  is characterized by all of the following except?

A) Platelet count is usually between 100,000 to 150,000/microL
B) No increased risk of bleeding or bruising
C) No risk of fetal thrombocytopenia
D) It is a diagnosis of exclusion
E) It may require plasmapheresis soon after delivery

Answer: E

Objective of the above question is to highlight the differential diagnosis between relatively benign gestational thrombocytopenia from other dreaded complications such as HELPP syndrome (Hemolysis with a microangiopathic blood smear, Elevated Liver enzymes, and a Low Platelet count).

#1 point of learning: if the platelet count is less than 80,000/microL, it should be evaluated more closely as gestational thrombocytopenia is usually benign (Choice A).

#2 point of learning: It should be approached as a diagnosis of exclusion due to high morbidity risk from other thrombocytopenias (choice D).

Gestational thrombocytopenia is usually benign and get resolve with end of pregnancy (Choices A,B and E)



1.  Reese JA, Peck JD, McIntosh JJ, et al. Platelet counts in women with normal pregnancies: A systematic review. Am J Hematol 2017; 92:1224.

2. Jaschevatzky OE, David H, Bivas M, et al. Outcome of pregnancies associated with marked gestational thrombocytopenia. J Perinat Med 1994; 22:351. 

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