Hepatitis C virus-associated thrombocytopenia in pregnancy: impact upon multidisciplinary care provision

J Perinat Med. 2014 Jan;42(1):135-8. doi: 10.1515/jpm-2013-0080.

Abstract

Objective: Recent studies have implicated hepatitis C virus (HCV) in the pathogenesis of immune thrombocytopenia. In pregnancy-associated immune thrombocytopenia, multidisciplinary management is required due to a potential for bleeding complications. We performed a retrospective review of HCV-infected pregnant women and age-matched controls who were not infected with HCV.

Methods: One hundred and six women with a HCV viral load were identified from 2009 to 2011.

Results: Thrombocytopenia was identified in 10.3% of HCV-infected pregnant women and 1.6% of age-matched controls (P<0.001). Mean platelet count during pregnancy was 120 ± 23 × 109/L in HCV-infected women and at delivery was significantly lower in HCV-infected women than in controls (P=0.01). Despite the significant difference in platelet counts, there was no significant difference in estimated blood loss (EBL) at delivery. Regional anaesthesia was performed in 73% of thrombocytopenic HCV-infected women and no complications were recorded. There were no fetal bleeding complications.

Conclusion: In the first study to date to investigate the impact of HCV on maternal platelet count we demonstrated a significantly higher frequency of thrombocytopenia and a significantly lower platelet count in HCV-infected pregnant women compared with controls. Interestingly, thrombocytopenia had no detectable impact on EBL at delivery.

MeSH terms

  • Blood Transfusion
  • Case-Control Studies
  • Female
  • Hepatitis C, Chronic / blood*
  • Humans
  • Incidence
  • Interdisciplinary Communication
  • Perinatal Care / organization & administration
  • Platelet Count
  • Postpartum Hemorrhage / etiology*
  • Postpartum Hemorrhage / prevention & control
  • Postpartum Hemorrhage / therapy
  • Pregnancy
  • Pregnancy Complications, Hematologic / epidemiology
  • Pregnancy Complications, Hematologic / immunology
  • Pregnancy Complications, Hematologic / therapy
  • Pregnancy Complications, Hematologic / virology*
  • Pregnancy Complications, Infectious / blood*
  • Retrospective Studies
  • Thrombocytopenia / epidemiology
  • Thrombocytopenia / immunology
  • Thrombocytopenia / therapy
  • Thrombocytopenia / virology*
  • Viral Load