Moderate to severe thrombocytopenia in the parturient

Objectives: To analyse patients with moderate to severe thrombocytopenia in labour, to identify the etiology, assess severity, correlate with the maternal disease and management. Methods: A retrospective study of all pregnant women admitted in labour or in obstetric critical area and found to have a low platelet count were included in a study period of 18 months from July 2013 to Dec 2014. Results: 25 women out of 2738 deliveries were identified and commonest cause was severe pre-eclampsia with or without HELLP. Coincidental dengue with super added pre-eclampsia was found in 3 women. Severe thrombocytopenia was found in haematological conditions like ITP and aplastic anemia. Conclusion: Low platelets or fall in platelets showed a worsening of disease condition. Platelet transfusion needs to be done if the cut off is below the desired target level. Timely administration of platelets and discrete use of SDP especially when massive platelet transfusion is required required as mandatory. Delivery should be as atraumatic as possible, avoidance of episiotomy to be practiced. Sometimes treatment can be challenging and involve multi-disciplinary approach.