Developed with members’, physicians’, and women’s health care professionals’ needs in mind, user-friendly features include: You’ll find clinical content written and peer reviewed by experts and valuable information that spans guidance on the diagnosis and management of the full spectrum of obstetric and gynecological conditions and clinical management issues. 166: Thrombocytopenia in Pregnancy. Birth defects after maternal exposure to corticosteroids: prospective cohort study and meta-analysis of epidemiological studies. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Uniformly small platelets are typically found in Wiskott-Aldrich syndrome. If the past medical history suggests frequent infections, quantitative immunoglobulin testing may be appropriate.14  If available, review of preexisting laboratory data may reveal abnormalities that preceded the pregnancy or were present only during a prior pregnancy. Testing for a lupus anticoagulant, antiphospholipid antibodies, and antinuclear antibody was negative. Disseminated intravascular coagulation (DIC) is usually associated with bleeding. Weinstein L. Syndrome of hemolysis, elevated liver enzymes, and low platelet count: a severe consequence of hypertension in pregnancy. When we have a high level of confidence that a patient has gestational thrombocytopenia, we check the platelet count at the time of each routine prenatal visit. A careful review of the peripheral blood smear remains the main diagnostic procedure. Rare cases have been reported with platelet counts at term 40-50 × 109/L. In most cases, it is an acquired disorder because of autoantibodies neutralizing ADAMTS13 activity.65  VWF-cleaving protease deficiency can also occur in DIC, HUS, preeclampsia, and HELLP.66  However, a severe deficiency (< 5% of the activity in normal plasma) appears to be specific for TTP.67, HUS is a more heterogeneous disease. Plasmapheresis is the first-line therapy. Bilirubin concentration, mainly conjugated, is frequently > 5 mg/dL. Epidural anesthesia in pregnant patients with low platelet counts. The general premis seemed to be that anything which increased the likelihood of bleeding would be a bad thing and therefore they would think twice about any form of intervention. Falsely low fetal platelet counts are encountered often. [5], Samuels evaluated 162 pregnant women and their infants with thrombocytopenia, 74 with presumed GT. I developed this condition at around 32 weeks but otherwise am fit and healthy.Does anyone else have any experience of this condition that they might be willing to share? [6], In Burrows' large 1993 study, 756 of 1027 women who were thrombocytopenic (73.6%) had GT. The frequency of the exchanges is guided by blood counts and serum lactate dehydrogenase (LDH) concentrations. von Willebrand factor-cleaving protease (ADAMTS13) in thrombocytopenic disorders: a severely deficient activity is specific for thrombotic thrombocytopenic purpura.