Low platelet levels during pregnancy, known as thrombocytopenia, can have many different causes, according to a review recently published in Life.
Platelets are blood cells that help stop bleeding. During pregnancy, platelet levels can drop due to normal changes in pregnancy or due to diseases like fetal and neonatal alloimmune thrombocytopenia (FNAIT).
“Therefore, identifying the underlying cause is essential, as treatment and prognosis vary significantly among different conditions,” the review authors said.
Doctors use medical history, blood tests and symptoms to find the cause. Treatment depends on the reason and how severe the condition is. Some cases only need monitoring, while others need urgent care.
Read more about FNAIT treatment and care
The most common cause is called gestational thrombocytopenia. It happens in about seven to eight out of 10 cases. This type is usually mild, appears in the second half of pregnancy and goes away after the baby is born.
Another cause is immune thrombocytopenia, which affects a smaller number of women (three to five out of every 100 cases). In this condition, the body attacks its own platelets. It can range from mild to severe and may need treatment.
Some serious pregnancy conditions, like preeclampsia and HELLP syndrome, can also cause low platelets, and are responsible for 5 to 10 out of every 100 cases of thrombocytopenia. These conditions can develop quickly and may lead to serious health problems for the mother. The only treatment option in these cases is emergency delivery.
Rare but dangerous causes include blood clotting disorders like thrombotic thrombocytopenic purpura. These can affect many organs and require urgent treatment.
Other less common causes include viral infections such as hepatitis and human immunodeficiency virus (HIV), certain medicines, and autoimmune diseases like lupus.
Because pregnant patients are a more vulnerable population, there is not as much data available for this population as for others. Most of what doctors know about thrombocytopenia comes from observing patients and looking back at past cases. This means doctors often need to look at each patient’s situation carefully before deciding on the best treatment.
Sign up here to get the latest news, perspectives, and information about FNAIT sent directly to your inbox. Registration is free and only takes a minute.
