Omoloye Ayooluwa K, Than Yu Kyi Pyar, Sagi Satyanarayana V, Samyraju Manjula, Oyibo Samson O
Internal Medicine, Peterborough City Hospital, Peterborough, GBR.
Diabetes and Endocrinology, Peterborough City Hospital, Peterborough, GBR.
Cureus. 2023 Jan 20;15(1):e34005. doi: 10.7759/cureus.34005. eCollection 2023 Jan.
Gestational thrombocytopenia is the commonest cause of thrombocytopenia in pregnancy, accounting for 70-80% of cases. It is a benign condition that recovers completely in the postpartum period. Although the cause is not fully understood, it is thought that pregnancy-related hemodilution and increased platelet consumption play a significant contributory role. Several life-threatening causes of thrombocytopenia in pregnancy make up the remaining 20-30% of cases. There are reports of recurrence of GT in women, but not many case reports document more than three consecutive episodes. We present a case of a young woman who had gestational thrombocytopenia during the third trimester of her four consecutive pregnancies, followed by complete recovery after each pregnancy. We ruled out other sinister and life-threatening causes of thrombocytopenia in pregnancy. During her four consecutive pregnancies, her platelet count fell below normal at the beginning of the third trimester, with a nadir towards the end. The other hematological indices, generally used as markers of hemodilution, remained in the normal pregnancy-specific reference range during each of her four pregnancies. This case argues against pregnancy-related hemodilution being a major factor in gestational thrombocytopenia. A systematic approach is paramount when differentiating the several causes of thrombocytopenia in pregnancy.
妊娠期血小板减少症是孕期血小板减少症最常见的病因，占病例的70 - 80%。它是一种良性病症，产后可完全恢复。尽管病因尚未完全明确，但据认为与妊娠相关的血液稀释和血小板消耗增加起了重要作用。妊娠期血小板减少症的其他一些危及生命的病因占其余20 - 30%的病例。有关于女性复发性妊娠期血小板减少症的报道，但记录连续发作超过三次的病例报告并不多。我们报告一例年轻女性，在其连续四次妊娠的第三个孕期均出现妊娠期血小板减少症，每次妊娠后均完全恢复。我们排除了妊娠期血小板减少症的其他严重及危及生命的病因。在她连续四次妊娠期间，她的血小板计数在第三个孕期开始时降至正常以下，在接近末期时达到最低点。其他通常用作血液稀释标志物的血液学指标，在她四次妊娠的每一次期间均保持在正常的孕期特定参考范围内。该病例表明，与妊娠相关的血液稀释并非妊娠期血小板减少症的主要因素。在区分妊娠期血小板减少症的多种病因时，系统的方法至关重要。
