EFFECT OF ASSOCIATION OF THROMBOCYTOPENIA WITH ANEMIA ON FETO-MATERNAL OUTCOME

Objectives: To find out effect of association of thrombocytopenia with anemia on feto-maternal outcome. Background: Thrombocytopenia is defined as platelet count less than 150,000/mm3. It is a second common hematological disorder in pregnancy, anemia being the most common. The exact mechanism of Anemia and Thrombocytopenia is not well understood. There is scarcity of literature on association between Anemia and Thrombocytopenia. Pubmed mostly revealed case reports and case series with only a few studies related to our topic. It is pertinent to mention here that most of the studies have been conducted on Paediatric age group. Therefore, the present study is planned to evaluate the effect of association of thrombocytopenia with anemia on feto-maternal outcome. Methodology : The study was conducted after taking informed consent from the patients in the Department of Obstetrics and Gynaecology, with the collaboration of Department of Pathology and Department of Pediatrics, JNMCH, AMU, Aligarh (U.P) on 360 pregnant women at 26-32 weeks of gestation. Complete Blood Count (CBC) and Red cell indices were calculated by Automated Haemotology (H3D Premier Diagnova) Analyzer. Type of anemia was determined on the basis of general blood smear and on indices. Appropriate therapy was given and response seen after 4 to 6 weeks. During labour and after delivery, feto-maternal outcome was evaluated. All the qualitative variables were analyzed using Pearson Chi square test while all quantitative variables were analyzed using independent sample test and Kruskal-Wallis one-way ANOVA test. Results: The association of thrombocytopenia with anemia was highest in cases of dimorphic anemia and lowest in cases of megaloblastic anemia while only 15% of control were having thrombocytopenia in the present study. The maternal outcome in terms of preterm labor, PPH, duration of hospital stay after delivery, maternal sepsis, DIC, bleeding from any other site between cases and controls was not significant. Fetal outcome between cases and controls in terms prematurity, birthweight, neonatal infections, NICU admissions, intracranial hemorrhage, still births was not statistically significant. Only the mean 1 minute Apgar score was lower in cases as compared to controls and this was statistically significant. Conclusion : It can be concluded that there is an association that exists between hemoglobin and platelet count. Appropriate therapy corrects anemia and improves platelet count. Timely detection and correction of anemia with thrombocytopenia reduces intrapartum and postpartum complications. In order to reduce maternal and neonatal morbidities, careful surveillance is required of all pregnancies for early detection and treatment of anemia.