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Review
. 2020 Dec;42(12):834-840.
doi: 10.1055/s-0040-1721350. Epub 2020 Dec 21.

Update on Thrombocytopenia in Pregnancy

Simone Filipa Carrasqueira Subtil  1 , Jorge Miguel Bastos Mendes  1 , Ana Luísa Fialho de Amaral Areia  1 , José Paulo Achando Silva Moura  1
Affiliations
Review

Update on Thrombocytopenia in Pregnancy

Simone Filipa Carrasqueira Subtil et al. Rev Bras Ginecol Obstet. 2020 Dec.

Abstract
in English, Portuguese

Thrombocytopenia, defined as platelet count < 150,000 mm3, is frequently diagnosed by obstetricians since this parameter is included in routine surveillance during pregnancy, with an incidence of between 7 and 12%. Therefore, decisions regarding subsequent examination and management are primordial. While most of the cases are due to physiological changes, as gestational thrombocytopenia, other causes can be related to severe conditions that can lead to fetal or maternal death. Differentiating these conditions might be challenging: they can be pregnancy-specific (pre-eclampsia/HELLP syndrome [hemolysis, elevated liver enzymes, low platelets]), or not (immune thrombocytopenia purpura, thrombotic thrombocytopenic purpura or hemolytic uremic syndrome). Understanding the mechanisms and recognition of symptoms and signs is essential to decide an adequate line of investigation. The severity of thrombocytopenia, its etiology and gestational age dictates different treatment regimens.

Trombocitopenia, definida como uma contagem de plaquetária < 150.000 mm3, é frequentemente diagnosticada pelos obstetras, uma vez que este parâmetro está incluído na vigilância de rotina durante a gravidez, com uma incidência de entre 7 e 12%. Assim, decisões relativas à avaliação e orientação subsequentes são primordiais. Embora a maioria dos casos ocorra devido a alterações fisiológicas, como a trombocitopenia gestacional, outras causas podem estar relacionadas com condições graves que podem levar à morte fetal ou materna. Distinguir entre estas entidades pode ser desafiante: elas podem ser específicas da gravidez (pré-eclâmpsia/síndrome HELLP [hemolysis, elevated liver enzymes, low platelets]) ou não (púrpura trombocitopênica imune, púrpura trombocitopênica trombótica ou síndrome hemolítico urêmico). Compreender os mecanismos e reconhecer os sinais e sintomas é essencial para decidir uma adequada linha de investigação. A severidade da trombocitopenia, a sua etiologia e a idade gestacional ditam regimes de tratamento diferentes.

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Conflict of interest statement

The authors have no conflict of interests to declare.

References

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