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)

#hematology
#obgyn



References:

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.