Does mild thrombocytopenia increase peripartum hemorrhage in elective cesarean deliveries? A retrospective cohort study.

Objective: To investigate the effect of mild thrombocytopenia (platelet count: 100 000-149 000/µl) on peripartum hemorrhage in elective cesarean deliveries.

Methods: This study was conducted between January 2018 and May 2019 in a hospital, located in Konya, Turkey. Uncomplicated pregnancies undergoing elective cesarean section were included. Of 1992 eligible patients, 201 women were determined as the mild thrombocytopenia group, 48 women as the severe thrombocytopenia group, and 1743 women as the control group. The estimated blood loss volume (EBLV), the need for blood transfusion, and excessive blood loss rates were compared among groups. Logistic regression analysis was performed for potential confounding factors.

Results: The EBLV and excessive blood loss ratios were significantly higher in the mild thrombocytopenia group compared with the control group (P < 0.001 and P < 0.05, respectively). There was no significant difference between the mild thrombocytopenia and control groups in terms of the number of patients receiving a blood transfusion. The probability of excessive blood loss was significantly higher in the mild thrombocytopenia group, even after adjusting the odds ratio for confounding factors (adjusted odds ratio 1.94, 95% confidence interval 1.27-2.95, P = 0.002).

Conclusion: Mild thrombocytopenia appears to increase the likelihood of peripartum hemorrhage in elective cesarean deliveries in uncomplicated pregnancies.