Thrombocytopenia in Pregnancy: A 5‐Year Analysis of Characteristics and Practices From a Tertiary Academic Center
- 1Division of Internal Medicine University of Utah Salt Lake City Utah USA
- 2Division of Hematology and Hematological Malignancies, Huntsman Cancer Institute University of Utah Salt Lake City Utah USA
Abstract
Background: Moderate‐to‐severe thrombocytopenia (platelet count < 100 × 109/L) occurs in fewer than 1% of pregnancies, posing management challenges, particularly surrounding eligibility for neuraxial anesthesia. Although recent anesthesia guidelines recommend a platelet threshold ≥ 70 × 109/L, outcomes data applying these recommendations in moderate‐to‐severe thrombocytopenia remain limited.
Methods: We conducted a retrospective study of 306 pregnancy encounters at a tertiary U.S. center (January 2018–December 2022) with ≥ 1 documented platelet count < 100 × 109/L. Etiology, platelet nadir, hematology consultation, treatment patterns, and neuraxial anesthesia (NA) use were assessed from antepartum through postpartum discharge.
Results: Gestational thrombocytopenia (gTCP) was the most common etiology (29%, n = 92). Thrombocytopenia severity differed across etiology, with higher platelet nadirs in gTCP (mean 84, median 88.5 × 109/L) compared with ITP (mean 62, median 66 × 109/L). Overall, 15% of pregnancies received hematology consultation, the majority of which were for individuals with ITP, and 78% underwent NA. Among pregnancies complicated by ITP, 71% received NA. Hematology consultation in ITP was associated with lower platelet nadirs and higher treatment rates.
Conclusions: In this cohort of moderate‐to‐severe thrombocytopenia, institutional adherence to guideline‐recommended platelet thresholds was high and associated with excellent neuraxial safety outcomes. These findings provide real‐world support for current anesthesia recommendations in a higher‐risk obstetric population.
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BibTeX
@article{lemieux2026thrombocytopenia,
title = {{Thrombocytopenia in Pregnancy: A 5‐Year Analysis of Characteristics and Practices From a Tertiary Academic Center}},
author = {Mackenzie E. Lemieux and Ming Y. Lim},
journal = {International Journal of Laboratory Hematology},
year = {2026},
month = jul,
doi = {10.1111/ijlh.70187},
url = {https://doi.org/10.1111/ijlh.70187},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Thrombocytopenia in Pregnancy: A 5‐Year Analysis of Characteristics and Practices From a Tertiary Academic Center
AU - Mackenzie E. Lemieux
AU - Ming Y. Lim
PY - 2026
DA - 2026/07/02
JO - International Journal of Laboratory Hematology
DO - 10.1111/ijlh.70187
UR - https://doi.org/10.1111/ijlh.70187
AB - Background: Moderate‐to‐severe thrombocytopenia (platelet count < 100 × 109/L) occurs in fewer than 1% of pregnancies, posing management challenges, particularly surrounding eligibility for neuraxial anesthesia. Although recent anesthesia guidelines recommend a platelet threshold ≥ 70 × 109/L, outcomes data applying these recommendations in moderate‐to‐severe thrombocytopenia remain limited. Methods: We conducted a retrospective study of 306 pregnancy encounters at a tertiary U.S. center (January 2018–December 2022) with ≥ 1 documented platelet count < 100 × 109/L. Etiology, platelet nadir, hematology consultation, treatment patterns, and neuraxial anesthesia (NA) use were assessed from antepartum through postpartum discharge. Results: Gestational thrombocytopenia (gTCP) was the most common etiology (29%, n = 92). Thrombocytopenia severity differed across etiology, with higher platelet nadirs in gTCP (mean 84, median 88.5 × 109/L) compared with ITP (mean 62, median 66 × 109/L). Overall, 15% of pregnancies received hematology consultation, the majority of which were for individuals with ITP, and 78% underwent NA. Among pregnancies complicated by ITP, 71% received NA. Hematology consultation in ITP was associated with lower platelet nadirs and higher treatment rates. Conclusions: In this cohort of moderate‐to‐severe thrombocytopenia, institutional adherence to guideline‐recommended platelet thresholds was high and associated with excellent neuraxial safety outcomes. These findings provide real‐world support for current anesthesia recommendations in a higher‐risk obstetric population.
SN - 1751-5521
SN - 1751-553X
ER -