# Thrombocytopenia in Pregnancy: Clinical Challenges, Maternal–Fetal Risks, and Management Strategies

## TL;DR

Thrombocytopenia in pregnancy affects up to 10% of women and requires careful diagnosis and management to prevent maternal and fetal complications.

## Contribution

This review provides a comprehensive overview of diagnostic approaches and management strategies for thrombocytopenia during pregnancy.

## Key findings

- Thrombocytopenia in pregnancy can arise from multiple causes, including immune-mediated conditions and preeclampsia.
- Accurate diagnosis is essential to guide treatment and improve maternal and neonatal outcomes.
- Management includes immunomodulatory therapies and platelet transfusions based on clinical evidence.

## Abstract

Thrombocytopenia affects up to 10% of pregnant women and represents the second most common blood disorder during pregnancy. Its causes include immune-mediated thrombocytopenia, hemolysis, elevated liver enzymes and low platelet count (HELLP) syndrome, preeclampsia (PE), and benign pregnant thrombocytopenia. Diagnosis is crucial because the cause dictates the effect on maternal health, pregnancy management, and neonatal outcomes. This narrative review examines the range of thrombocytopenia during pregnancy, primarily focusing on diagnostic evaluation, underlying pathophysiological causes, and differential diagnosis. In addition, it organizes maternal and fetal complications that might be caused by the condition, such as bleeding, preterm birth, and neonatal thrombocytopenia. Moreover, current patient management based on available evidence and clinical practice is discussed, including immunomodulatory therapies, platelet transfusions, clinical monitoring, and supportive care. A thorough and clinically guided approach to thrombocytopenia in pregnancy is indispensable for maximizing maternal and fetal outcomes and facilitating the personalization of perinatal care.