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Colegio de Medicina Interna de México.

2021, Number 4

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Med Int Mex 2021; 37 (4)

Comprehensive and practical approach to thrombocytopenia in pregnancy

Aguilar-Hidalgo JA, Duarte-Mote J, Ezeta MME, Serdán-Gutiérrez R, Gutiérrez-Alvarado DA, Ulloa-García JC, Romero-Guzmán IG

Language: Spanish
References: 16
Page: 559-571
PDF size: 274.85 Kb.


ABSTRACT

Thrombocytopenia is defined as a platelet count lesser than 150 x 109, it is the second most frequent hematologic abnormality found in pregnancy. Its prevalence ranges from 6.6% to 11.6%, and is conditioned by physiological and pathological changes, of which many are unique in pregnancy. Among the most frequent causes are: 75% gestational thrombocytopenia, 15-20% is related to hypertensive disorders, HELLP syndrome, preeclampsia, immune diseases, microangiopathic thrombocytopenia. Its approach must be multidisciplinary in joint with anesthetic and perinatal management, monitoring complications and seeking the trigger etiology. Most of thrombocytopenias are mild and their fetal repercussion is rare; however, the early recognition and assessment is important in order to distinguish between the hemato-physiological alterations of pregnancy and pathological thrombocytopenia not associated with pregnancy. The diagnosis is complex, but this review has been carried out to facilitate it, taking into account the most frequent causes not associated with pregnancy that can cause this blood dyscrasia, making an approach from the point of view of the internist. Medical treatment is controversial, since some of these conditions may have an impact on maternal-fetal mortality. It is important that the clinician assess the possibility of bleeding against the cost-benefit of diagnostic tests and invasive procedures.


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