Research Progress on the Etiology and Pregnancy Outcomes of Thrombocytopenia During Pregnancy
Journal: Journal of Clinical Medicine Research DOI: 10.32629/jcmr.v6i1.3721
Abstract
Thrombocytopenia during pregnancy is a common hematological abnormality with complex and diverse etiologies, involving physiological changes during pregnancy, immune factors, genetic factors, and other underlying diseases. Based on etiology, thrombocytopenia during pregnancy can be classified into pregnancy-specific and non-pregnancy-specific categories. The impact of thrombocytopenia caused by different etiologies on pregnancy outcomes varies. This article reviews the common etiologies of thrombocytopenia during pregnancy and related research progress on pregnancy outcomes, aiming to provide a theoretical basis for early clinical identification, diagnosis, and appropriate intervention to improve maternal and fetal prognosis.
Keywords
thrombocytopenia during pregnancy, preeclampsia, immune thrombocytopenia, pathogenesis, pregnancy outcomes
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[36] Elshoeibi AM, Ferih K, Elsabagh AA, Elsayed B, Elhadary M, Marashi M, Wali Y, Al-Rasheed M, Al-Khabori M, Osman H, Yassin M. Applications of Artificial Intelligence in Thrombocytopenia. Diagnostics (Basel). 2023, 13(6): 1060.
[2] Chen, D. J., Zhang, L. Z., Chen, J. S. Multidisciplinary diagnosis and management of thrombocytopenia in pregnancy. Chinese Journal of Practical Gynecology and Obstetrics, 2022, 38(12), 1153-1155.
[3] Li, L. P., Ying, H. Etiology and differential diagnosis of thrombocytopenia in pregnancy. Chinese Journal of Practical Gynecology and Obstetrics, 2022, 38(12), 1166-1170.
[4] Ruszala M, Poniedziałek-Czajkowska E, Mierzynski R, Wankowicz A, Zamojska A, Grzechnik M, Golubka I, Leszczynska-Gorzelak B, Gogacz M. Thrombocytopenia in pregnant women. Ginekol Pol. 2021, 92(8): 587-590.
[5] Tian, X., Huo, G. G., Wang, R. Q. Etiology and perinatal outcomes of thrombocytopenia in pregnancy. Chinese Journal of Clinical Obstetrics and Gynecology, 2021, 22(3), 291-292.
[6] Zhou, L., Zhang, X. Q. Etiology and impact of thrombocytopenia in pregnancy on delivery mode and maternal-neonatal outcomes. Chinese Journal of Women and Children, 2021, 36(3), 499-502.
[7] Gardikioti A, Venou TM, Gavriilaki E, Vetsiou E, Mavrikou I, Dinas K, Daniilidis A, Vlachaki E. Molecular Advances in Preeclampsia and HELLP Syndrome. Int J Mol Sci. 2022, 23(7): 3851.
[8] Pishko AM, Levine LD, Cines DB. Thrombocytopenia in pregnancy: Diagnosis and approach to management. BloodRev. 2020, 40: 100638.
[9] Law KS, Wei TY. Effect of Low-Dose Aspirin in Preventing Early-Onset Preeclampsia in the Taiwanese Population-A Retrospective Cohort Study. Int J Womens Health. 2021,12(13): 1095-1101.
[10] Robillard PY, Dekker G, Scioscia M, Bonsante F, Boukerrou M, Iacobelli S, Tran PL. Preeclampsia in 2023: Time for preventing early onset- and term preeclampsia: The paramount role of gestational weight gain. J Reprod Immunol. 2023, 158: 103968.
[11] Jelcic D, Puzovic V, Benzon B, Palada I, Jerković J, Vulic M. Immunohistochemical Expression of Placental Vitamin D Receptors in Pregnancies Complicated by Early and Late-Onset Preeclampsia. Acta Med Okayama. 2023, 77(4): 415-422.
[12] Gao Y, Wang X, Li X, Fang Y, Lv C, Chen D. Association between platelet counts and clinical outcomes in acute fatty liver of pregnancy: A retrospective cohort study. Int J Gynaecol Obstet. 2024, 164(1): 173-183.
[13] van Oostwaard MF, Langenveld J, Schuit E, Papatsonis DN, Brown MA, Byaruhanga RN, et al. Recurrence of hypertensive disorders of pregnancy: an in- dividual patient data metaanalysis. Am J Obstet Gynecol. 2015, 212(624): e1–17.
[14] Petito E, Gresele P. Immune attack on megakaryocytes in immune thrombocytopenia. Res Pract Thromb Haemost. 2024, 8(1): 102345.
[15] Chen, Y. H., Li, L. B., Zhou, Z. H. Characteristics of bone marrow megakaryocytes in primary immune thrombocytopenia (ITP) with antinuclear antibody (ANA)-positive patients. Journal of Practical Clinical Medicine, 2024, 28(24), 48-52.
[16] Gao, Y. H., Li, J., Su, J. Primary immune thrombocytopenia (ITP) in pregnancy. International Journal of Gynecology and Obstetrics, 2022, 49(1), 60-66.
[17] Liu XG, Hou Y, Hou M. How we treat primary immune thrombocytopenia in adults. J Hematol Oncol. 2023, 16(1): 4.
[18] Giagounidis A. Differenzialdiagnose und Therapie der Immunthrombozytopenie [Differential diagnosis and therapy of immune thrombocytopenia. Dtsch Med Wochenschr. 2024, 149(15): 895-903.
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[20] Zhou, M., Shao, Y., Shan, X. Y. Efficacy and safety of eltrombopag combined with cyclosporine for refractory immune thrombocytopenia (ITP). Journal of Practical Clinical Medicine, 2022, 26(10), 51-53.
[21] Hou, M., Wang, L. Diagnosis and treatment strategy of primary immune thrombocytopenia (ITP) in pregnancy. J Clin Hematol, 2022, 35(7), 461-463.
[22] Markham-Lee Z, Morgan NV, Emsley J. Inherited ADAMTS13 mutations associated with Thrombotic Thrombocytopenic Purpura: a short review and update. Platelets. 2023, 34(1): 2138306.
[23] Fodil S, Zafrani L. Severe Thrombotic Thrombocytopenic Purpura (TTP) with Organ Failure in Critically Ill Patients. J Clin Med. 2022, 11(4):1103.
[24] Trisolini SM, Laganà A, Capria S. Immune Thrombotic Thrombocytopenic Purpura: Pathophysiology, Diagnosis, Therapy and Open Issues. Mediterr J Hematol Infect Dis. 2024, 16(1): e2024060.
[25] Zheng Z, Liu J, Yun M, Deng L, Xiang P, Jiang M, Wang R, Liu C. Immune thrombocytopenia in patients with systemic lupus erythematosus. Clin Rheumatol. 2024, 4.
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[28] Bahar Keleşoğlu Dinçer A, Erkan D. The ABCs of antiphospholipid syndrome. Arch Rheumatol. 2023, 38(2): 163-173.
[29] Arachchillage DRJ, Pericleous C. Evolution of Antiphospholipid Syndrome. Semin Thromb Hemost. 2023, 49(3): 295-304.
[30] Sugraliyev AB. [Heparin-Induced Thrombocytopenia]. Kardiologiia. 2024, 64(5): 18-25.
[31] Selvadurai MV, Favaloro EJ, Chen VM. Mechanisms of Thrombosis in Heparin-Induced Thrombocytopenia and Vaccine-Induced Immune Thrombotic Thrombocytopenia. Semin Thromb Hemost. 2023, 49(5): 444-452.
[32] Strauss G, Mott K, Klopocki E, Schulze H. Thrombocytopenia Absent Radius (TAR)-Syndrome: From Current Genetics to Patient Self-Empowerment. Hamostaseologie. 2023, 43(4): 252-260.
[33] Ikeda N, Shoji H, Ikuse T, Ohkawa N, Kashiwagi K, Saito Y, Shimizu T. A case of neonatal thrombocytopenia due to maternal Helicobacter pylori-associated immune thrombocytopenia. Helicobacter. 2023, 28(3): e12976.
[34] Fang Y, Shen S, Zhang J, Xu L, Wang T, Fan L, Zhu Q, Xiao J, Wu X, Jin J, Wu Q, Zhang Y, Tang S, Zheng X, Deng F. Thrombocytopenia in SFTS due to platelets with altered function undergoing cell death pathways. J Infect Dis. 2024, 12: 355.
[35] Point F, Terriou L, Rakza T, Drumez E, Alluin G, Garabedian C, Houfflin-Debarge V. Risk factors for severe neonatal thrombocytopenia in cases of maternal immune thrombocytopenia. Acta Paediatr. 2022, 111(5): 985-991.
[36] Elshoeibi AM, Ferih K, Elsabagh AA, Elsayed B, Elhadary M, Marashi M, Wali Y, Al-Rasheed M, Al-Khabori M, Osman H, Yassin M. Applications of Artificial Intelligence in Thrombocytopenia. Diagnostics (Basel). 2023, 13(6): 1060.
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