Thrombocytopenia in Pregnancy

Thrombocytopenia is second only to anemia as a common hematological abnormality occurring during pregnancy, and is observed in approximately 8-10% of pregnancies [1]. It may result from a number of causes ranging from benign disorders like gestational thrombocytopenia to life threatening illnesses, e.g., HELLP syndrome, that are associated with variable degree of maternal and fetal morbidity and mortality. During pregnancy, there is usually a decrease in platelet count, especially towards the end of pregnancy. This is mainly due to dilutional effect by increased plasma volume and accelerated platelet destruction across the placenta [2,3]. Majority of females have platelet counts within normal range; however, if platelet count was towards the lower limit of normal range in the initial part of pregnancy, there may be a steeper decline and thus thrombocytopenia may set in towards the later part of pregnancy. It is advisable that before labeling the patient as thrombocytopenic, factitious thrombocytopenia should be ruled out first by reviewing peripheral blood film.