The evaluation of maternal and fetal results of pregnancy withgestational thrombocytopenia

Aim: We planned to investigate the relationship between gestational thrombocytopenia and adverse maternal and fetal outcomes in pregnant women. Material-Method: The study, which was planned as a retrospective case study, was carried out between January 2010 and May 2021 in the Gynecology and Obstetrics Clinic of Dicle University Medical Faculty Hospital. 97 patients who were diagnosed with gestational thrombocytopenia during pregnancy and had no another disease that cause thrombocytopenia and delivered in our clinic were included in the study. The patients were divided into two groups according to their platelet values. Group-1 platelet count was <70.000/mm3 and Group-2 platelet count was 70.000- 150.000/mm3. Subgroups were compared among themselves. Current data and laboratory results of patients and infants were obtained by scanning the files backwards and by calling the patients by telephone. Analysis of data between groups was made. In the analysis of negative perinatal outcomes, logistic regression analysis was performed. P <0.05 was considered significant in the analysis results. Results: From the laboratory data of the patients diagnosed with gestational thrombocytopenia, mean platelet count was 85.28±27.08 (min-max: 22-142) and mean hematocrit was 35.91±3.63 (min-max: 21-45). When the groups were evaluated considering their hematocrit values; the mean hematocrit value of the patients in Group-2 (36.42 ± 3.22) was higher than the mean hematocrit value (34.26 ± 4.39) of the patients in Group-1, and a statistically significant difference was found between them (p:0.03). This statistically significant difference was also present when the platelet value was taken as the limit of 110,000 (p:0.039). ALT values in Group-1 (16.27±10.89) were statistically significantly higher than Group-2 (13.52±9.57) (p:0.01). However, no significant difference was found between the two groups in terms of AST, creatinine, urea, APTT, PT, INR, APGAR 1 minute mean, birth weight and fetal height (p>0.05). When the incidence of obstetric complications, additional surgical intervention and the need for maternal intensive care were compared, no significant difference was found between the two groups in terms of any of these parameters (p>0.05). In Group-2, the 5th minute mean APGAR score (8.49 ± 0.97) was found to be significantly higher than in Group-1 (7.96 ± 0.88) (p:0.01). The rate of needing blood transfusion was significantly higher in Group-1 than in Group-2 (p:0.001). There was a statistically significant difference between the groups in terms of erythrocyte transfusion (p: 0.033). This statistically significant difference was also present when the platelet value was taken as the limit of 80,000 (p: 0.002). The need for platelet transfusion was found to be significantly higher in Group-1 than in Group-2 (p:0.01). It was observed that this statistically significant difference continued even when the border platelet value was taken as 100,000 (p:0.013). It was observed that the need for FFP transfusion was statistically higher in Group-1 than in Group-2 (p:0.02). There was no statistically significant difference between the two groups in terms of neonatal thrombocytopenia (p:0.139). Even when the cut-off value was taken as 50,000, no statistically significant difference was found in terms of neonatal thrombocytopenia (p:0.455). It was observed that gestational thrombocytopenia could recur in subsequent pregnancies. Conclusion: Apgar scores are lower in patients diagnosed with gestational thrombocytopenia and with platelet values below 70,000, and the need for blood transfusion (erythrocyte suspension, FFP and platelet product) is higher. The need for erythrocyte transfusion continues even when the platelet limit is 80,000, and the need for platelet transfusion is 100,000. Key words: Gestational Thrombocytopenia, Pregnancy, Adverse Maternal and Fetal Outcomes