14. Thrombocytopenia

  1. John T. Queenan MD2,
  2. Catherine Y. Spong MD3 and
  3. Charles J. Lockwood MD4
  1. Robert M. Silver MD

Published Online: 4 JAN 2012

DOI: 10.1002/9781119963783.ch14

Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition

Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition

How to Cite

Silver, R. M. (2012) Thrombocytopenia, in Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition (eds J. T. Queenan, C. Y. Spong and C. J. Lockwood), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781119963783.ch14

Editor Information

  1. 2

    Department of Obstetrics and Gynecology, Georgetown University School of Medicine, Washington, DC, USA

  2. 3

    Bethesda, MD, USA

  3. 4

    Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA

Author Information

  1. Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT, USA

Publication History

  1. Published Online: 4 JAN 2012
  2. Published Print: 24 FEB 2012

ISBN Information

Print ISBN: 9780470655764

Online ISBN: 9781119963783

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Keywords:

  • thrombocytopenia;
  • maternal thrombocytopenia, and antepartum diagnosis;
  • thrombocytopenia, platelet count, less than 150,000/µL;
  • ITP, immunologically mediated thrombocytopenia;
  • maternal thrombocytopenia, and GTP;
  • splenectomy, effective for ITP;
  • fetal thrombocytopenia, and autoimmune thrombocytopenia;
  • NAIT, life-threatening, 1 in 1000–2000 live infants;
  • fetal ICH in utero, antenatal ultrasound diagnosis;
  • optimal timing of initial cordocentesis, uncertain

Summary

The antepartum diagnosis of maternal thrombocytopenia has become more common because platelet counts are now routinely obtained as part of prenatal screening. Although thrombocytopenia is classically defined as a platelet count of less than 150,000/µL, there is a physiologic drop in platelet count during pregnancy of 10–30% secondary to hemodilution and increased consumption. The most common causes of maternal thrombocytopenia include gestational thrombocytopenia, preeclampsia/hemolysis, elevated liver enzymes, and low platelet count syndrome, and autoimmune thrombocytopenia. These conditions have implications for both mother and fetus. Thus, it is important to consider both maternal and fetal thrombocytopenia.