Relationship Between Peripartal Management Of Pregnancy With Thrombocytopenia And Pregnancy Outcome

Objective:To investigate the cause, the peripartal management, the termination and the delivery mode of pregnant women with thrombocytopenia.Methods:Retrospective analysis of the clinical data of 194 pregnancies with thrombocytopenia in our obstetric intensive care center from July 2004 to June 2014. Patients were divided into 3 groups according to severity: mild group(platelet count?50×109/L), moderate group(30×109/L?platelet count < 50×109/L), severe group(platelet count<30×109/L). Patients in severe group were divided into 3 groups according to management: Group A(without glucocorticoids or immunoglobulin), Group B(glucocorticoids only), Group C(glucocorticoids and immunoglobulin).Results:There was a total of 194 cases, of which PAT had the highest incidence. 8 cases had early termination of pregnancy medically. There was 1 maternal death. 192 infants were delivered including 6 twins. There was 2 neonatal death. There was no neonatal intracranial hemorrhage. The gestational duration was lower in severe group than that in moderate group(P<0.01). The amount of blood loss between 3 groups had no statistical significance(P>0.05). The birth weight was lower in severe group than that in moderate group(P<0.01). The rate of premature birth in severe group was high than that in moderate group(P<0.01). The birth weight had no statistical significance among Group A, B, C(P>0.05). Glucocorticoids was used more in patients of PAT, ITP, TTP, SLE and UTCD. Platelet transfusion was mainly used in severe thrombocytopenia.Conclusion:There are many causes of pregnancy with thrombocytopenia, each should have different management. Thrombocytopenia is not an indication of pregnancy termination. Most patients with regular medical check-ups can pass their gestation safely. TTP and HELLP syndrome has poor prognosis and should be given attention. Early detection, early diagnosis and early treatment can reduce the injury.