Document Detail


Causes of thrombocytopenia in triplet gestations.
MedLine Citation:
PMID:  12861159     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The purpose of this study was to determine the incidence and cause of thrombocytopenia in triplet gestations. STUDY DESIGN: All triplet gestations that received prenatal care and were delivered at our hospital between 1993 and 2001 were identified. Serial platelet values were reviewed from the earliest gestational age available until the postpartum period. Mild and severe thrombocytopenia were defined as a platelet count of 100000 to 150000/microL and <100000/microL, respectively. The cause of the thrombocytopenia was determined from a review of medical records. RESULTS: One hundred twenty-six triplet pregnancies met the inclusion criteria. The mean maternal age was 34.3 +/- 5.4 years, 85.7% of the patients were nulliparous, and at least 92.1% of the patients had received infertility treatment. The overall rate of thrombocytopenia in our triplet population was 36.5%. Mild thrombocytopenia occurred in 19.0% of pregnancies, and severe thrombocytopenia occurred in 17.5% of pregnancies. The causes of thrombocytopenia were severe preeclampsia (54.3%), gestational (23.9%), mild preeclampsia (8.7%), HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count syndrome; 4.3%), atypical preeclampsia (4.3%), idiopathic thrombocytopenic purpura (2.2%), and familial (2.2%). Thrombocytopenia occurred significantly earlier before the diagnosis of preeclampsia. CONCLUSION: Approximately one third of triplet gestations are complicated by thrombocytopenia, one half of which are severe. This represents a much higher frequency as compared with the 6.6% to 11.6% that was reported for singleton gestations. Hypertension-associated disorders of pregnancy account for 71.7% of thrombocytopenia in triplets, unlike singleton gestations in which 75% of thrombocytopenia is gestational. The single most common cause of thrombocytopenia in triplets is severe preeclampsia. This is the first study to evaluate the incidence and cause of thrombocytopenia in a large set of triplet gestations.
Authors:
Huda B Al-Kouatly; Stephen T Chasen; Robin B Kalish; Frank A Chervenak
Related Documents :
11810089 - Spontaneous reduction of multiple pregnancy: incidence and effect on outcome.
18598609 - Global epidemiology of multiple birth.
15672019 - Fetofetal transfusion syndrome in triplet pregnancies: outcome after endoscopic laser s...
7268599 - Quintuplet gestation. a case report.
8141219 - A prospective comparison of the outcome of triplet pregnancies managed expectantly or b...
10719409 - Nutrition and multifetal pregnancy.
16487879 - Metabolic diseases and pregnancy.
6695049 - Studies of the teratogenic potential of exposure of rats to 6000-mhz microwave radiatio...
6183629 - Acute pancreatitis in pregnancy: two case reports.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  189     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-07-15     Completed Date:  2003-08-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  177-80     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, New York Presbyterian Hospital-Weill Medical College of Cornell University, New York, NY, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Female
HELLP Syndrome / complications
Humans
Parity
Pre-Eclampsia / complications
Pregnancy
Pregnancy Complications, Hematologic*
Pregnancy, Multiple*
Purpura, Thrombocytopenic, Idiopathic / complications
Reproductive Techniques, Assisted
Thrombocytopenia / epidemiology,  etiology*
Triplets*
Comments/Corrections
Comment In:
Am J Obstet Gynecol. 2004 Jun;190(6):1797; author reply 1797-8   [PMID:  15290818 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  First-trimester sex hormone binding globulin and subsequent gestational diabetes mellitus.
Next Document:  Beneficial impact of term labor: nonenzymatic antioxidant reserve in the human fetus.