II. Epidemiology
- Most common cause of Thrombocytopenia in Pregnancy
-
Incidence: 8-10% of pregnant women
- Responsible for 70% of Thrombocytopenia in Pregnancy
- Occurs in late pregnancy or early postpartum
III. Pathophysiology
- Increased Platelet clearance
- Hemodilution
IV. Labs
- Complete Blood Count
- Peripheral Blood Smear
-
Platelet Count
- Mild to moderate isolated Thrombocytopenia (70,000 to 150,000 per mm3)
V. Evaluation
- No additional evaluation required if
- Platelet Count >112,000 per mm3
- No signs of Preeclampsia or HELLP Syndrome
- Discuss lower Platelet Counts with hematology or maternal fetal medicine
- Obtain Platelet Count in newborns if maternal Immune Thrombocytopenic Purpura is suspected
VI. Differential Diagnosis
- See Thrombocytopenia
- Immune Throbocytopenic Purpura (<0.1% of pregnancies)
- Most common in the first and early second trimesters (but may occur in any trimester)
-
Preeclampsia with HELLP Syndrome
- Thrombocytopenia occurs in 20% of Preeclampsia patients
- Preeclampsia presents with Hypertension, Proteinuria, edema, Headache, hyperreflexia and visual disturbance
- HELLP Syndrome (10-20% of Preeclampsia patients) presents with Hemolytic Anemia, Thrombocytopenia, high LFTs
VII. Management
- Gestational Thrombocytopenia is typically followed outpatient without intervention required
- Evaluate and admit pregnant patients with significant acute Thrombocytopenia
- Suggests alternative cause other than Gestational Thrombocytopenia
VIII. Course
- Resolves spontaenously after delivery
IX. Prognosis
- Benign condition with no associated increased morbidity or mortality in pregnant women or newborns
X. References
- Dave, Hoag, Jundoria and Lopez (2026) Crit Dec Emerg Med 40(2): 26-35
- Gauer (2012) Am Fam Physician 85(6): 612-22 [PubMed]
- Ruggeri (1997) Haematologica 82(3): 341-2 [PubMed]