282) A 32 year old woman is seen in the antenatal clinic during her regular antenatal visit. This is her first pregnancy and she is at 32 weeks gestation. She takes prenatal vitamins. She currently has no complaints. Physical examination is benign. Laboratory investigations reveal:
WBC 10k/µl
Hemoglobin 14 g/dL,
Mean cell volume (MCV) 84 fL
Platelet count 70k/µl
Liver function tests, Electrolytes, Creatinine, Prothrombin time and Partial thromboplastin time are within normal limits. A peripheral blood smear shows reduced number of platelets with out any schistocytes or blasts or nucleated red cells. Antinuclear antibodies, HIV testing and Hepatitis C are negative. The patient is concerned about her abnormal platelet counts. She denies any easy bruising or nose bleeds or gross bleeding. Her complete blood count 3 months ago was completely normal.
Which of the following is the most appropriate response?
A) “You will require treatment with steroids”
B) “Urgent delivery with cesarean section is required.”
C) “Your platelet count will normalize within 2 to 12 weeks after delivery”
D) “You will require Bone marrow biopsy”
E) “No treatment needed since it is immune thrombocytopenia”
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Gestational thrombocytopenia
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