Frequency of Thrombocytopenia and Its Etiologies in the Last Trimester of Pregnancy

Frequency and Causes of Third Trimester Thrombocytopenia

Abstract

Thrombocytopenia is a frequent hematological abnormality in late pregnancy with diverse etiologies and potential maternal-fetal implications. Objective: To determine the frequency of thrombocytopenia and its etiologies in pregnant women in the last trimester. Methods: A descriptive cross-sectional study was conducted in the Department of Obstetrics and Gynecology, Sheikh Zayed Hospital, Rahim Yar Khan, from June to December 2025. A total of 210 pregnant women in the third trimester were enrolled through non-probability consecutive sampling. Demographic and obstetric data were recorded, and platelet counts were assessed using a complete blood count. Thrombocytopenia severity and etiologies were determined using standardized clinical and laboratory criteria.  Results: Among 210 women evaluated in the last trimester, the mean maternal age was 29.63 ± 5.03 years, and the mean gestational age was 36.46 ± 3.21 weeks. Mean gravidity and parity were 2.79 ± 1.26 and 1.90 ± 1.26, respectively, with overall platelet count 210.26 ± 57.04 ×10³/µL. Thrombocytopenia was detected in 26 (12.4%). Platelet counts differed significantly between thrombocytopenia and non-thrombocytopenia groups (115.73 ± 32.45 vs 223.61 ± 46.08 ×10³/µL; p<0.001). Severity was mild in 18 (69.2%), moderate in 6 (23.1%), and severe in 2 (7.7%). Gestational thrombocytopenia predominated (57.7%), followed by pre-eclampsia (11.5%), eclampsia (7.7%), disseminated intravascular coagulation (7.7%), infection-related causes (7.7%), HELLP syndrome (3.8%), and immune thrombocytopenic purpura (3.8%) overall. Conclusions: Thrombocytopenia affected 12.4% of late-pregnancy women, mostly mild. Gestational thrombocytopenia predominated, with smaller contributions from hypertensive disorders, disseminated intravascular coagulation, and infections.