Thrombocytopenia

Question 1

DDx of thrombocytopenia

Answer 1

• Gestational (dx of exclusion)
• ITP
• SLE/APLS
• HUS/TTP/DIC
• PET/HELLP
• AFLP
• Drug induced

Question 2

Basic thrombocytopenia Ix

Answer 2

• FBE/UEC/LFT +/- uPCR
• Blood film + Coag +/- Hemolysis screen
• ANA/aPLs (SLE/APLS screen)

Question 3

Mx - AN/intrapartum/postpartum

Answer 3

• M risk - PPH/regional
• F risk - ICH
• MDI - Obs/Obs med/Haem
• +/- tert ref
• monthly till 36/40
• 2 weekly from 36/40
• weekly if <100 or unstable
• optimize Hb/Ferritin
• if ITP - pred/IVIG/plt transfusion
• > =80 for regional analgesia
• > =50 for NVD or CS
• IP - no FSE/FBS/VE/high forcep if ITP
• PP
  1. active 3rd, cord plt
  2. inform paeds, no IM
  3. LWMH ok if plt >50
  4. Haem F/U