Thrombocytopenia in pregnancy: Diagnosis and approach to management

Blood Rev. 2020 Mar:40:100638. doi: 10.1016/j.blre.2019.100638. Epub 2019 Nov 6.

Abstract

Thrombocytopenia during pregnancy presents unique challenges for the hematologist. Obstetricians generally manage many of the pregnancy-specific etiologies, ranging from the benign (gestational thrombocytopenia) to the life-threatening (preeclampsia; hemolysis, elevated liver enzymes and low platelets syndrome; and acute fatty liver of pregnancy). However, hematologists may be consulted for atypical and severe presentations and to help manage non-pregnancy specific etiologies, including immune thrombocytopenia, thrombotic thrombocytopenic purpura, hemolytic uremic syndrome and antiphospholipid syndrome, among others, in which maternal and fetal risks must be considered. This review provides a general approach to the diagnosis and management of thrombocytopenia in pregnancy for the consulting hematologist.

Keywords: Gestational thrombocytopenia; Hemolytic uremic syndrome; Immune thrombocytopenia; Preeclampsia; Pregnancy; Thrombocytopenia; Thrombotic thrombocytopenic purpura; von Willebrand disease.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Female
  • Humans
  • Pregnancy
  • Pregnancy Complications, Hematologic* / diagnosis
  • Pregnancy Complications, Hematologic* / therapy
  • Thrombocytopenia* / diagnosis
  • Thrombocytopenia* / therapy