Mild thrombocytopenia and the risk for postpartum hemorrhage in twin pregnancies.

Abstract

OBJECTIVE:

We aimed to investigate the association of mild thrombocytopenia with postpartum hemorrhage (PPH) and blood transfusion among women with twin gestations.

METHODS:

A retrospective cohort study (Jan 2015 to May 2019) was performed. Women with twin pregnancies and pre-delivery mild thrombocytopenia were compared to those with normal platelet count. The primary outcome was the rate of PPH, defined as a composite of one or more of the following: (1) need for packed red blood cell transfusion; (2) postpartum hemoglobin decline of ≥3 g/dL; and (3) the use of postpartum uterotonics agents in addition to oxytocin.

RESULTS:

Of 1085 women who were included in final analysis, 315 (30.9%) had mild thrombocytopenia (and 770 (69.1%) served as controls. The rate of PPH was increased in the study group (14% vs. 9.4%, P = 0.03), as was the use of uterotonic agents (3.8% vs. 1.3%, respectively, P = 0.02). The rate of blood product transfusion and hemoglobin decline >3 g/dL was not significantly different between the groups. In multivariate logistic regression analysis, mild thrombocytopenia was associated with a higher risk for PPH (OR 1.55 [95% CI 1.02-2.35], P = 0.02).

CONCLUSION:

Mild thrombocytopenia in twin pregnancies is associated with an increased risk of interventions such as the use of uterotonic agents.

• Authors: Emmanuel Attali, Danny Epstein, Michael Lavie, Anat Lavie, Lee Reicher, Yariv Yogev, Eran Ashwal, Liran Hiersch
• Journal: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics (Int J Gynaecol Obstet) Vol. 159 Issue 3 Pg. 790-795 (Dec 2022) ISSN: 1879-3479 [Electronic] United States
• PMID: 35307829 (Publication Type: Journal Article)
• Copyright: © 2022 International Federation of Gynecology and Obstetrics.

Chemical References

• Ergonovine
• Oxytocics
• Oxytocin

Topics

• Female
• Humans
• Pregnancy
• Ergonovine
• Oxytocics
• Oxytocin
• Postpartum Hemorrhage (epidemiology, etiology)
• Pregnancy, Twin
• Retrospective Studies
• Thrombocytopenia (epidemiology)