Maternal thrombocytopenia (<150,000 platelets/µL) occurs in 5 to 10% of pregnancies. Differential diagnosis can be difficult, but it is essential to offer appropriate antenatal monitoring and treatment. Indeed, thrombocytopenia during pregnancy can lead to maternal, fetal, and neonatal complications.
After ruling out pseudothrombocytopenia, a distinction is made between isolated thrombocytopenia (gestational thrombocytopenia and immune thrombocytopenic purpura) and thrombocytopenia associated with hemolytic anemia (pre-eclampsia, HELLP syndrome and microangiopathies). In this article, we will describe these different pathologies in detail and offer diagnostic keys, before outlining current knowledge regarding treatment, antenatal monitoring, delivery, as well as neonatal period and post-partum periods.
An algorithm to facilitate the differential diagnosis of thrombocytopenia in pregnant women is proposed at the end of this article.
What is already known about the topic?
Thrombocytopenia is a frequent pathology during pregnancy and is too often labelled as gestational thrombocytopenia. The differential diagnosis is varied.
What does this article bring up for us?
This article provides a review of recent literature and an easily accessible practical tool for correct diagnosis of thrombocytopenia, based on appropriate antenatal and neonatal management.
Keywords
Thrombocytopenia, pregnancy, hypoplaquettosis