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Case Report



Thrombocytopenia in pregnancy followed by thrombocytopenia in the baby

I Made Dharma Pramana, Ni Kadek Mulyantari, Sianny Herawati.




Abstract
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Thrombocytopenia in pregnancy is a common finding. Although associated with the physiological processes of pregnancy, in moderate and severe cases of thrombocytopenia many pathological processes can cause it. Gestational induced thrombocytopenia is the first common cause for thrombocytopenia in pregnancy. Immune thrombocytopenic purpura is the second cause. It is hard to diagnose thrombocytopenia in pregnancy due to the lack of a single specific test to differentiate it, but with clinical and laboratory findings in the mother and infant, the diagnosis can be made. Some cases will be followed by the occurrence of thrombocytopenia in the babies. A 26 years old pregnant woman came with a chief complaint of fever 3 days before being admitted to the hospital. History of thrombocytopenia since 5 months of gestation and has been hospitalized several times for thrombocytes concentrate transfusions. Physical examination revealed fever with laboratory results of leukocytosis and thrombocytopenia, blood smear showing large platelets. The babies born with cesarean delivery, aterm, with physical examination within normal limits with laboratory results also thrombocytopenia and blood smear images also showed large platelets. This case report highlights the way to distinguish Immune thrombocytopenic purpura in pregnancy and gestational induced thrombocytopenia from thrombocytopenia severity, associated with fetal thrombocytopenia, platelets resolved after delivery and abnormalities on complete blood count.

Key words: Thrombocytopenia, Immune thrombocytopenic purpura, Pregnancy, Gestational induced thrombocytopenia, Maternal immune thrombocytopenic purpura






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