DefinePK

Research Objective

To determine the association of thrombocytopenia (mild, moderate & severe) with pregnancy-related disorders.

Methodology

Cross-sectional study conducted in the Department of Haematology of Pakistan Railway Hospital, Rawalpindi, Pakistan, in collaboration with the Departments of Obstetrics and Gynecology of Pak Emirates Military Hospital and Fuji Foundation Hospital, Rawalpindi, Pakistan, from October 2018 to October 2019. Seventy-five pregnant females with a platelet count <150x10^9/L were included. Blood samples were analyzed for complete blood count, peripheral blood smear, manual platelet count, uric acid, urinary proteins, liver function tests, lactate dehydrogenase, coagulation profile, and viral serology (Hepatitis B & C). Statistical analysis was performed using SPSS version 21.0, with the chi-square test and Fisher's exact test applied for association analysis.

Methodology Flowchart

                        graph TD
    A["Recruit 75 pregnant females with platelet count <150x10^9/L"] --> B["Collect blood samples"];
    B --> C["Analyze blood samples for CBC, smear, LFTs, coagulation profile, etc."];
    C --> D["Diagnose pregnancy-related disorders"GT, PEC, HELLP, ITP""];
    D --> E["Assess severity of thrombocytopenia"mild, moderate, severe""];
    E --> F["Analyze data using chi-square and Fisher's exact tests"];
    F --> G["Determine association between thrombocytopenia severity and disorders"];                    

Discussion

Thrombocytopenia is a frequent hematological anomaly in pregnancy. Gestational thrombocytopenia is the most common cause, typically presenting as mild thrombocytopenia. Preeclampsia is associated with moderate thrombocytopenia, while HELLP syndrome and immune thrombocytopenic purpura are more frequently linked to severe thrombocytopenia. Prompt and accurate diagnosis is crucial for managing these conditions to ensure maternal and fetal safety.

Key Findings

Gestational thrombocytopenia was the most common cause (74.7%), followed by preeclampsia (17.3%), HELLP syndrome (4%), and immune thrombocytopenic purpura (4%). Mild thrombocytopenia was most frequent in gestational thrombocytopenia (62.5%). Moderate thrombocytopenia was common in preeclampsia (84.6%). Severe thrombocytopenia was mostly identified in patients with HELLP syndrome (66.7%) and immune thrombocytopenic purpura (66.7%).

Conclusion

Mild thrombocytopenia is most commonly associated with gestational thrombocytopenia and can be managed with follow-up. Moderate thrombocytopenia is frequently observed in preeclampsia, and severe thrombocytopenia is usually diagnosed in HELLP syndrome and immune thrombocytopenic purpura, all of which require timely diagnosis and urgent management to protect both mother and fetus.

Fact Check

1. Gestational thrombocytopenia was the most common cause of thrombocytopenia in pregnancy, accounting for 74.7% of cases in the study.
2. Mild thrombocytopenia was observed in 62.5% of patients with gestational thrombocytopenia.
3. Severe thrombocytopenia was identified in 66.7% of patients with HELLP syndrome and 66.7% of patients with immune thrombocytopenic purpura.

Mind Map