high platelet count during pregnancy

2004;69(11):2599-606. In certain cases, increased platelet count can give rise to serious complications as a result of unexplained blood clotting. The interaction between the mean platelet counts in the women with preexisting disorders and the mean platelet counts in the women with uncomplicated pregnancies was not significant (P=0.07), which indicated that the rates of decrease in platelet counts did not differ significantly (Fig. If you have HELLP syndrome once, your risk increases for having it again. The mean platelet counts in the nonpregnant women and in the women with uncomplicated pregnancies in the first trimester and at the time of delivery were normally distributed, except for a slight skew toward higher values in all three cases (Fig. When we evaluated all 10,296 platelet count values measured during pregnancy and at the time of delivery in women with pregnancy-related complications (Fig. Otherwise we will assume you agree to continue. Normal Platelet Value Range Negative Pregnancy Adult: 165 to 415X103/mm3X103/l or 165 to 415X109/L Pregnancy Trimester One: 174 to 391X103/mm3X103/l or 174 to 391X109/L ), the HematologyOncology Section, Department of Medicine, College of Medicine (J.A.R., J.N.G. Each trimester calls for different nutritional needs due to hormonal and physiological changes. Pathophysiology, classification, and complications of common asymptomatic thrombocytosis in newborn infants. The name HELLP syndrome stands for: . A total of 59 women with pregnancy-related complications (2.3%) had platelet counts of less than 100,000 per cubic millimeter during pregnancy or at the time of delivery. Most women experience symptom improvement within two days of giving birth. 39 Thrombocytopenia defined as a platelet count less than 150 10 9 /L complicates approximately 8-10% of pregnancies. Pooling of platelets in the spleen: role in the pathogenesis of hypersplenic thrombocytopenia. Pregnancy complications. If you already have a platelet disorder, pregnancy may make your condition worse. A severe lack of folic acid in your blood can cause thrombocytopenia, so it is important to take your prenatal vitamins. Test results can also help find out what type of platelet disorder you have. If you have a platelet disorder during pregnancy, you may need to see a doctor who specializes in high-risk pregnancies. HELLP syndrome was named by Dr. Louis Weinstein in 1982 after its characteristics: For the analysis of the NHANES data, we used the sampling weights provided by NHANES to account for the complex survey design, which included oversampling of some populations, and to account for cases in which participants either did not respond to the survey or did not complete all aspects of the survey.12,13 To compare the platelet counts of the pregnant women with those of the nonpregnant women from NHANES, we calculated weighted mean platelet counts for all the nonpregnant women overall and also separately for each subgroup of nonpregnant women defined according to race or ethnic group and age. 2B). In some cases, if there are no symptoms, no treatment may be required. To determine the course of platelet counts throughout pregnancy, at the time of delivery, and during the postpartum period, we selected only one platelet count measurement from each time point for each woman: the first platelet count measurement during each trimester and the postpartum period and the platelet count measurement preceding and closest to the time of delivery. Among the women who had uncomplicated pregnancies, the mean platelet count in the first trimester (mean gestation, 8.7 weeks) was 251,000 per cubic millimeter, which was lower than the mean platelet count in the 8885 nonpregnant women (273,000 per cubic millimeter) (P<0.001). 1). Pregnancy loss occurs frequently in women with essential thrombocytosis, a case history by lead author Gokhan Anil, MD reports in The Female Patient. Seven longitudinal studies reported a decrease in platelet counts during pregnancy, while four reported no change. What causes high platelet count in pregnancy? 2019;69(684):e462-e469. Among all 15,385 women who had singleton pregnancies, 4760 women had pregnancy-related complications. Platelet counts of less than 150,000 per cubic millimeter at the time of delivery were more common among women who had pregnancy-related complications than among women who had uncomplicated pregnancies (11.9% vs. 9.9%, P = 0.01). When determining whether or not a high platelet count is something to worry about, healthcare providers may look for symptoms like bruising, bleeding, as well as signs of infection or another underlying condition. Platelet counts of less than 80,000 per cubic millimeter for which an alternative cause was not identified occurred in only 5 women (0.1%), none of whom had a platelet count below 62,000 per cubic millimeter. Short and long-term stress is associated with platelet aggregation, which is when they group together near an injury site. In healthy, nonpregnant adult women, one third of all circulating platelets are transiently pooled within the low flow-rate circulation of the splenic sinusoids; an increased spleen size results in more pooling of the platelets and a lower platelet count.17 Therefore, the 50% increase in spleen size that occurs during pregnancy18 would also contribute to a lower platelet count. The mean platelet count was 251,000 per cubic millimeter in the first trimester of pregnancy (mean gestation, 8.7 weeks), 230,000 per cubic millimeter in the second trimester (mean gestation, 22.0 weeks), 225,000 per cubic millimeter in the third trimester (mean gestation, 32.1 weeks), 217,000 per cubic millimeter at the time of delivery (mean gestation, 39.0 weeks), and 264,000 per cubic millimeter during the postpartum period (mean time after delivery, 7.1 weeks). Johns Hopkins Medicine. Up to 1 in 5 women who have preeclampsia or eclampsia develop HELLP syndrome. However, having a high platelet count can lead to clotting problems and, in some cases, may be associated with serious conditions, like cancer. Hypertension in pregnancy: report of the American College of Obstetricians and Gynecologists Task Force on Hypertension in Pregnancy. Other disorders can happen, too: . Once the underlying cause resolves or is managed, platelet counts generally return to normal levels. Pregnancy-related complications, such as pre-eclampsia, may also cause thrombocytopenia.4,810 Therefore, it may be hypothesized that platelet counts in women who have pregnancy-related complications are lower than platelet counts in women who have uncomplicated pregnancies. Curtin LR, Mohadjer LK, Dohrmann SM, et al. Increased platelet volume is indicative of younger platelets, suggesting some increase in platelet turnover in pregnancy. On rare occasions, primary thrombocytosis can turn into certain types of cancer. 174 - 391. The mean platelet counts in the women who had uncomplicated pregnancies and in the nonpregnant women are shown in Figure 2A and Table 1. Cancer incidence following a high-normal platelet count: cohort study using electronic healthcare records from English primary care. 155 - 409. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Hypertensive disorders of pregnancy and postpartum readmission in the United States: national surveillance of the revolving door. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. Platelet counts of less than 150,000 per cubic millimeter during uncomplicated pregnancies are described as gestational thrombocytopenia if no alternative cause is identified. Department of Biostatistics and Epidemiology, College of Public Health (J.A.R., J.D.P., D.R.T., S.K.V., J.N.G. Platelet Counts during Pregnancy and at the Time of Delivery.*. Gernsheimer T, James AH, Stasi R. How I treat thrombocytopenia in pregnancy. Aster RH. Haematologica. National Heart, Lung, and Blood Institute. The Function of Blood Platelets or Thrombocytes, Understanding Your MPV Blood Test Results, Low Platelet Count (Thrombocytopenia) During Cancer Treatment. doi:10.1182/blood.2020007214. For example, spleen removal surgery, or a splenectomy, is significantly associated with secondary thrombocytosis, impacting up to 90% of individuals who undergo this procedure. The mean platelet counts in these women decreased significantly throughout pregnancy (P<0.001) and were lower in all three trimesters and at the time of delivery than the mean platelet counts in the women who had uncomplicated pregnancies (P<0.04 for all comparisons). . Platelet counts during normal pregnancy. An additional 7 women who had platelet counts of less than 80,000 per cubic millimeter had other causes for their thrombocytopenia. Figs. 6 However, this is temporary, with platelet counts tending to return to normal quickly. If you have thrombotic thrombocytopenic purpura, you may need treatment for your condition during your pregnancy even if you do not have any symptoms. Thrombocytosis, or high platelets, is defined as persistently greater than 450,000 platelets/microliter. 3, and Table S2 in the Supplementary Appendix). In some cases this is due to a problem that existed prior to pregnancy; in others, it comes on during pregnancy. Throughout their pregnancies and deliveries, 59 women (2.3%) with pregnancy-related complications had a platelet count below 100,000 per cubic millimeter, and 31 (1.2%) had a platelet. Vaccine . 2022;65(4):182-187. doi:10.3345/cep.2021.00864, Kucine N, Chastain KM, Mahler MB, Bussel JB. Placental abruption in the United States, 1979 through 2001: temporal trends and potential determinants. The mean platelet count at the time of delivery was higher in non-Hispanic black women than in non-Hispanic white women and Hispanic women (P<0.001) and was higher in younger women (15 to 19 years of age) than in older women (20 to 44 years of age) (P<0.001). Less common causes include systemic lupus erythematosus . He was a physician in the US Air Force and now practices at MD Anderson Cancer Center, where he is an associate professor. A person with thrombocytopenia has a platelet count of fewer than 150,000 platelets per L. Hepatogastroenterology. Thank you, {{form.email}}, for signing up. Reactive, or secondary, platelet levels mean that another disease process, such as inflammation or cancer, is causing an increase in platelets, the Cleveland Clinic explains. The alternative causes for the thrombocytopenia that were identified in the other 7 women were immune thrombocytopenic purpura (2 women), pseudothrombocytopenia due to in vitro platelet clumping (2 women), error in measurement of platelet count (2 women), and hereditary thrombocytopenia (1 woman). J Neuroimmune Pharmacol 500512 (2021). An abnormally high number of platelets in pregnancy is far less common than low platelet levels. Data on nonpregnant women 15 to 44 years of age from the National Health and Nutrition Examination Survey (NHANES) from 1999 through 2012 were used for comparisons. If you have a very low platelet count, you may need treatment to raise it before you deliver your baby. Cancer is linked to both primary and secondary thrombocytosis. When all the women with uncomplicated singleton or twin pregnancies who had a platelet count at the time of delivery (8051 women with singleton pregnancies and 93 with twin pregnancies) were evaluated, the mean platelet count in the women with twin pregnancies (197,000 per cubic millimeter; 95% confidence interval [CI], 182,000 to 212,000) was significantly lower than the count in the women with singleton pregnancies (214,000 per cubic millimeter; 95% CI, 213,000 to 215,000) (P = 0.03) at the time of delivery.

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