Thrombocytopenia and pregnancy

Thrombocytopenia is the decrease in the amount of circulating platelets (platelet count) in the bloodstream, below normal levels. The lack of platelets can lead to poor coagulation and be at greater risk of hemorrhaging.

Below you have an index with all the points that we will discuss in this article.

Index

Thrombocytopenia and pregnancy

• 1. Signs and symptoms of Thrombocytopenia
• 2. Types of thrombocytopenia
• 2.1. Thrombocytopenia
• 2.2. Thrombotic thrombocytopenic purpura
• 2.3. Alloimmune thrombocytopenia
• 2.4. Thrombocytopenia associated with hypertension

Signs and symptoms of Thrombocytopenia

The symptoms are diverse, these can be: bodily hematomas, nosebleeds, presence of blood in the urine and feces, oral bleeding and gums, rash, expectoration with blood and bruises under the skin.

It should be noted that the presence of these symptoms depends to a large extent on the degree of thrombocytopenia. In cases of very low platelet counts, the consequences for health are high and hospital treatments and controls must be performed through blood tests.

Thrombocytopenia

Types of Thrombocytopenia

During pregnancy we can have different types.

Thrombocytopenia

It is considered the most frequent of all. It occurs in many healthy pregnant women, in which the decrease in platelets in the blood is due to the hemodilution of pregnancy. This type of thrombocytopenia usually disappears after delivery or the first months of the baby's life. The mother usually does not present symptoms and no damage has been described in the fetus and the newborn, although it is advisable to refer the pregnant woman to assess a treatment with corticosteroids.

Delivery may be vaginal but epidural anesthesia and internal monitoring should be avoided when platelets are at low levels.

Thrombotic thrombocytopenic purpura

It is an autoimmune disorder, which results in the formation of antiplatelet antibodies. So the mother does not recognize her own platelets and they are more susceptible to being destroyed. The problem is that the antibodies of the IgG type, cross the placenta reaching the fetus and also destroy the fetal platelets.

In the mother they cause a decrease in the level of platelets observed in the different tests performed during pregnancy. They usually have bleeding gums, nose, mucous and other skin may appear bruises and small red dots. In these cases, treatments with corticosteroids and sometimes with intravenous immunoglobulins will be carried out by the specialists.

A decrease in the level of platelets also occurs in the fetus, and cerebral hemorrhages can occur. For this reason the newborn will be monitored with blood tests and brain ultrasound to rule out neurological damage.

Alloimmune thrombocytopenia

It is also an immunological disorder, in which the mother produces fetal antiplatelet antibodies because she recognizes them as foreign. According to experts it is similar to the incompatibility of blood groups and Rh, but with platelets.

The platelet levels of the pregnant woman are normal and she has no symptoms. However, the fetus has decreased levels of platelets. Most often, pregnancy and childbirth take place without incident, but when the baby is born, bruises or red dots (petechiae) are seen in the body that alarm parents and health personnel.

Thrombocytopenia associated with hypertension

It occurs in extreme situations, is associated with an increase in blood pressure, swelling of feet and increased levels of liver enzymes.

When this situation occurs, the mother must be admitted and an urgent cesarean section is performed to save the life of the mother and the fetus. When the fetus has not reached lung maturity, the pregnant woman should be given a corticoid before performing the cesarean section. You also have to transfuse platelets to the mother before the caesarean to avoid bleeding.