H M Sebitloane1. 1. Department of Obstetrics and Gynaecology, School of Clinical Medicine, College of Health Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa. sebitloanem@ukzn.ac.za.
Abstract
UNLABELLED: Background. Thrombocytopenia (TCP) complicates 5 - 8% of pregnancies. Most cases of TCP are gestational, and the condition is usually mild and occurs in the latter part of pregnancy. Apart from pregnancy-associated medical complications such as pre-eclampsia, HIV infection is a recognised cause of TCP, and a relatively high prevalence of TCP during pregnancy would be expected in a setting with a high antenatal seroprevalence of HIV. METHODS: This was a sub-analysis of the data from a prospective trial in which the incidence of postpartum sepsis in HIV-infected women was compared with that in HIV-uninfected women. Women who were considered at low risk and eligible for vaginal delivery were recruited at 36 weeks' gestation, and followed up for 6 weeks after delivery. Full blood counts and CD4counts of HIV-infected women were obtained at baseline and repeated 6 weeks after delivery. RESULTS: The prevalence of TCP was 5.3% during pregnancy and 1.2% 6 weeks after delivery. The prevalence was similar among HIV-infected (6.0%) and HIV-uninfected women (4.7%) (p=0.292). Among the HIV-infected women, who were not receiving antiretroviral therapy (mean CD4 cell count of 453 cells/µL), there was no significant association between immunosuppression and the severity of TCP. CONCLUSIONS: Most of the TCP seen during pregnancy is of the gestational variety, and in this study HIV infection did not increase its prevalence or its severity.
UNLABELLED: Background. Thrombocytopenia (TCP) complicates 5 - 8% of pregnancies. Most cases of TCP are gestational, and the condition is usually mild and occurs in the latter part of pregnancy. Apart from pregnancy-associated medical complications such as pre-eclampsia, HIV infection is a recognised cause of TCP, and a relatively high prevalence of TCP during pregnancy would be expected in a setting with a high antenatal seroprevalence of HIV. METHODS: This was a sub-analysis of the data from a prospective trial in which the incidence of postpartum sepsis in HIV-infectedwomen was compared with that in HIV-uninfectedwomen. Women who were considered at low risk and eligible for vaginal delivery were recruited at 36 weeks' gestation, and followed up for 6 weeks after delivery. Full blood counts and CD4counts of HIV-infectedwomen were obtained at baseline and repeated 6 weeks after delivery. RESULTS: The prevalence of TCP was 5.3% during pregnancy and 1.2% 6 weeks after delivery. The prevalence was similar among HIV-infected (6.0%) and HIV-uninfectedwomen (4.7%) (p=0.292). Among the HIV-infectedwomen, who were not receiving antiretroviral therapy (mean CD4 cell count of 453 cells/µL), there was no significant association between immunosuppression and the severity of TCP. CONCLUSIONS: Most of the TCP seen during pregnancy is of the gestational variety, and in this study HIV infection did not increase its prevalence or its severity.
Authors: Igor Grabovac; Nicola Veronese; Sinisa Stefanac; Sandra Haider; Sarah E Jackson; Ai Koyanagi; Michael Meilinger; Brendon Stubbs; Joseph Firth; Pinar Soysal; Francesco Di Gennaro; Jacopo Demurtas; Daragh T McDermott; Adam D Abbs; Lin Yang; Lee Smith Journal: Clin Infect Dis Date: 2020-04-15 Impact factor: 9.079