Oral Presentation Society of Obstetric Medicine of Australia and New Zealand ASM 2018

Thrombocytopenia in Pregnancy (#11)

Renee Eslick 1
  1. Haematology Department, Liverpool Hospital, Sydney, NSW, Australia

Thrombocytopenia is a common problem encountered in obstetric medicine, affecting an estimated 7-10% of pregnancies.1 The most common aetiology is gestational thrombocytopenia, but a broad range of obstetric and medical causes must be considered. There are few randomised control trials to guide patient treatment, and management guidelines are primarily based on expert opinion.  The presentation, assessment and current treatment recommendations of common causes of obstetric thrombocytopenia will be discussed.

Deciding on a safe platelet threshold to administer neuraxial anaesthesia is a particularly contentious area. There is increasing evidence that neuraxial anaesthesia can be safely administered at platelet counts above 70x109/L, with the documented risk of epidural haematoma estimated at <0.2%.2

The most recent findings from a multicentre thrombocytopenia in pregnancy study will be discussed; with pertinent findings presented, including opportunities for improvement in practice. There are plans to expand this study into a national registry.

  1. Myers B. Diagnosis and management of maternal thrombocytopenia in pregnancy. British Journal of Haematology, 2012, 158, 3-15.
  2. Lee LO, Bateman BT, Kheterpal S et al. Risk of epidural hematoma after neuraxial techniques in thrombocytopenic parturients: a report from the multicentre perioperative outcomes group. Anesthesiology, 2017, 126:1-12.