Thrombocytopenia in Pregnancy
Publication Date: March 1, 2019
Last Updated: March 14, 2022
Recommendations
Maternal thrombocytopenia between 100 x 109/L and 149 x 109/L in asymptomatic pregnant women with no history of bleeding problems is usually due to gestational thrombocytopenia. (B)
574
Given the very low risk of serious neonatal hemorrhage, the mode of delivery in pregnancies complicated with immune thrombocytopenia should be determined based on obstetric considerations alone. (B)
574
Consensus guidelines recommend platelet transfusion to increase the maternal platelet count to more than 50 x 109/L before major surgery. (C)
574
Epidural or spinal anesthesia is considered acceptable, and the risk of epidural hematoma is exceptionally low in patients with platelet counts of 70 x 109/L or more provided that the platelet level is stable, there is no other acquired or congenital coagulopathy, the platelet function is normal, and the patients are not on any antiplatelet or anticoagulant therapy. (C)
574
Fetal–neonatal alloimmune thrombocytopenia should be suspected in cases of otherwise unexplained fetal or neonatal thrombocytopenia, hemorrhage, or ultrasonographic findings consistent with intracranial bleeding. (C)
574
Recommendation Grading
Overview
Title
Thrombocytopenia in Pregnancy
Authoring Organization
American College of Obstetricians and Gynecologists
Publication Month/Year
March 1, 2019
Last Updated Month/Year
April 1, 2024
Document Type
Consensus
External Publication Status
Published
Country of Publication
US
Inclusion Criteria
Female, Adolescent, Adult
Health Care Settings
Ambulatory, Hospital
Intended Users
Nurse midwife, nurse, nurse practitioner, physician, physician assistant
Scope
Management
Diseases/Conditions (MeSH)
D013921 - Thrombocytopenia
Keywords
thrombocytopenia