Gestational thrombocytopenia affects 5-10% of women with uncomplicated pregnancies. In order to gain a better understanding of the normal course of platelet counts and the potential severity of gestational thrombocytopenia, researchers evaluated platelet counts of 7351 pregnant women who delivered at Oklahoma University Medical Center from 2011 to 2014. Platelet counts decreased from the first trimester to the time of delivery among all pregnant women without complications, those with complications [defined for this study as hypertension, diabetes, preeclampsia, HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count), preterm birth, stillbirth, and placental abnormalities], and those with pre-existing platelet disorders. The mean platelet count for women with uncomplicated pregnancies was 251,000 per mm2 in the first trimester, 230,000 per mm2 in the second trimester, 225,000 per mm2 in the third trimester, and 217,000 per mm2at delivery (n=4568). During the postpartum period, platelet counts returned to normal levels among women with uncomplicated pregnancies compared to platelet counts of non-pregnant women (p=0.10). Gestational thrombocytopenia (platelet counts less than 150,000 per mm2) was more common in women with complicated pregnancies than those with uncomplicated pregnancies (11.9% vs 9.9%; p=0.01). Severe thrombocytopenia was rare (0.1% and 1.2% in women with uncomplicated and complicated pregnancies, respectively); it is important to consider other etiologies of thrombocytopenia other than pregnancy.
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