What Is Gestational Thrombocytopenia?

Gestational thrombocytopenia is a low platelet count in pregnancy that is usually benign. It is the leading cause of thrombocytopenia in pregnancy and is not at all uncommon, although a patient’s obstetrician may request some additional testing to confirm the diagnosis and rule out other possible causes of a low platelet count. This testing ensures that the patient will receive the most appropriate care. Typically, women with gestational thrombocytopenia can deliver vaginally and shouldn’t experience additional risks in pregnancy because of their platelet counts, although other medical conditions could create complications.

Routine blood testing during pregnancy may reveal a drop in platelet levels, potentially showing early warning signs of complications that need to be addressed to protect the health of mother and fetus. Abnormalities on the test results, however, are not an immediate cause for worry, as there can be benign explanations. In the event a test shows a problem like a reduction in the patient’s platelets, the next step is more testing to determine what is going on, to see if any action needs to be taken.

Some drop in the total number of platelets tends to be normal in pregnancy. Women produce a higher volume of plasma and consume platelets more quickly while pregnant. In some cases, this causes platelet counts to dip below the diagnostic threshold for thrombocytopenia. Patients with gestational thrombocytopenia are asymptomatic and don’t have a history of bleeding during the pregnancy, indicating that the reduced number of platelets is not causing any problems.

Another important diagnostic criterion for this condition is no previous history of thrombocytopenia. Blood tests performed before the pregnancy should reveal a normal level of platelets, indicating that the patient usually has healthy blood chemistry. The thrombocytopenia should also be mild to moderate; severe drops in platelet levels are a cause for concern because they are associated with other conditions. In addition, the fetus should be healthy, with no signs of distress.

If a patient meets all these criteria, she likely has gestational thrombocytopenia rather than a more serious platelet-related condition. The final criterion is difficult to check for during the pregnancy, as it involves waiting for several weeks after the birth and testing the patient’s blood again to confirm that the platelet levels have returned to normal. Patients with cases of gestational thrombocytopenia can be monitored to see if they develop symptoms or their platelets keep dropping, both indicators that something more serious is going on and intervention may be necessary.