Obstetric prognosis of the gestational thrombocytopenia

To define clinical outcomes of marked gestational thrombocytopenia (GT) (< 100,000/mm(3)) we identified twenty-nine infants born to 28 pregnancies at 26 women with GT among 8,364 deliveries during the years 1993-1999. Cordoce ntesis was performed in 7 mothers with platelet counts less than 75.000/mm( 3). Cord blood platelet count was checked in all cases at delivery. The mos t significant decrease of platelet count in pregnancy with GT was less than 50,000/mm(3) in 6 pregnancies (21.4%) and between 50,000 and 100,000/mm(3) in 22 pregnancies (78.6%). In pregnancies with GT, 2 neonates (6.9%) had m ild thrombocytopenia and 1 neonate (3.4%) moderate thrombocytopenia. Severe thrombocytopenia was not observed in any neonate born to mothers with GT. There were no cases of coagulation disturbance at delivery or in the postpa rtum period. Fourteen cases for which follow-up was carried out recovered p latelet counts to more than 100,000/mm(3) within one month postpartum. Two patients who became pregnant twice noticed recurrence of GT. In conclusion, GT is not associated with bleeding diathesis in the mother: resolves spont aneously during the postpartum period, and can recur in subsequent gestatio ns, and the association of severe fetal/neonatal thrombocytopenia is very r are. No intervention is necessary during pregnancy or delivery, apart from a careful maternal and fetal surveillance if there is no obstetric indicati on.