PRELIMINARY ASSESSMENT OF THROMBOCYTOPENIA IN WOMEN WITH EXCESSIVE BLOOD LOSS DURING CHILDBIRTH

Thrombocytopenia, characterized by a platelet count below 150 × 10⁹/L, affects 7-12% of pregnancies and is associated with an elevated risk of postpartum hemorrhage (PPH), a leading cause of maternal morbidity and mortality worldwide. This review synthesizes data from multiple retrospective cohort studies, including large-scale analyses of over 23,000 deliveries, to evaluate the preliminary assessment of thrombocytopenia and its linkage to PPH. Key findings indicate that thrombocytopenia <150 × 10⁹/L occurs in approximately 10.4% of deliveries, with an adjusted odds ratio (aOR) of 1.34 (95% CI 1.14–1.59) for PPH compared to normal counts. The risk escalates with severity: severe (<50 × 10⁹/L) aOR 2.24 (95% CI 1.01–4.94), moderate (50–99 × 10⁹/L) aOR 1.22 (95% CI 0.77–1.93), and mild (100–149 × 10⁹/L) aOR 1.31 (95% CI 1.10–1.56). Moderate thrombocytopenia (50–100 × 10⁹/L) further increases PPH risk fourfold (aOR 4.7, 95% CI 2.1–10.8), particularly in blood group O carriers (aOR 11.0, 95% CI 2.4–49.6). Additional factors, such as lower plateletcrit (aOR 1.15 per 0.05% decrease) and elevated platelet distribution width (PDW ≥23%, aOR 6.05), contribute to heightened risk. In cesarean deliveries, mild thrombocytopenia triples PPH odds (aOR 3.74, 95% CI 1.36–10.30). Correlations with coagulation factor XIII activity reveal prepartum Spearman r=0.228 (p<0.001) and postpartum r=0.293 (p<0.001), suggesting interplay in hemostasis. Python-based visualization, including bar charts, illustrates risk gradients across platelet categories. Preliminary assessment emphasizes routine monitoring from the second trimester, especially in high-risk groups like those with blood group O or comorbidities, to prevent PPH through targeted interventions. This expanded analysis underscores the need for integrated risk models incorporating platelet indices and etiological subgroups for improved maternal outcomes.

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