What can be the long-term consequences of thrombocytopenia?
In principle, if the platelet count is permanently lowered, bleeding events with the following complications can occur. Nevertheless, bleeding due to thrombocytopenia or thrombocytopathy (e.g. due to ASA therapy) is usually limited to petechial skin bleeding. Rather, this symptomatology is more an indication for a diagnostic intervention than that these petechial hemorrhages have far-reaching prognostic value. Nevertheless, thrombocytopenia can occur in combination with various serious diseases such as certain anemias (e.g. pernicious anemia) and leukemias as well as other bone marrow diseases. A broader diagnostic spectrum, such as laboratory diagnostics or instrumental diagnostics, should be used to prevent possible complications.
Thrombocytopenia in pregnancy – what can this mean?
In about 5-10% of all pregnancies, women form a slight drop in platelet count. This means a decrease in the number of thrombocytes by 15% (so-called pregnancy thrombopenia). Thus, this slight drop in platelet count is the second most common pathological change in blood count after manifest pregnancy anemia.
The slight thrombocyte deficiency occurs primarily in the last trimester (third trimester) of pregnancy. In general, a drop in platelet count is associated with an increased tendency to bleeding complications in the form of petechiae (small punctiform bleedings of the skin). However, it is important to differentiate between a weak and a strong drop.
With relatively weak drop, as in most cases of pregnancy thrombopenia, bleeding is not to be expected in some cases, since the organism only shows decompensation of blood clotting at very low platelet numbers. A thrombocytopenia must also be distinguished with regard to the cause of the disease. In the most common form of pregnancy thrombocytopenia (gestational thrombocytopenia), there is usually no danger to mother and child in the form of bleeding complications.With autoimmune thrombocytopenia, on the other hand, the mother may have an increased tendency to bleed during the period of birth.
In the newborn, severe bleeding can also occur due to the transfer of autoantibodies against thrombocytes through the placenta. In principle, if bleeding occurs in mother and child in the form of cerebral haemorrhages or all organ bleeding, several manifestations are possible. In terms of differential diagnosis, it is very important to distinguish these typical complication-free pregnancy thrombocytopenia from other clinical pictures.
In particular, it is important to distinguish them from the complications that often develop during pregnancy, the HELLP syndrome and eclampsia (pregnancy poisoning). Chronologically, HELPP means an occurring hemolysis (destruction of blood cells of different genesis), an increase in liver enzymes and a decrease in the number of thrombocytes. While the first two diagnostic abnormalities in particular can lead to symptomatic complications, normal gestational thrombocytopenia usually turns out to be an asymptomatic phase of pregnancy. No symptoms are to be expected after birth either. On the contrary, laboratory thrombocytopenia disappears within a short time.
