June 6th, 2020

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Termination of Second Trimester Pregnancy Affected by Thrombocytopenia
Authors:  Jie Ou, Ph.D., and Xinyan Liu, Ph.D.
  OBJECTIVE: To evaluate the methods and the process of terminating a second trimester pregnancy affected by thrombocytopenia.

STUDY DESIGN: A retro­spective analysis of 17 cases in Peking Union Medical College Hospital from De­cember 1980 to December 2017. Seventeen patients had a pregnancy termination due to surgical and/or fetal dis­ease and were found with different levels of thrombocy­topenia. They were grouped by platelet number: Group I included patients whose platelet number was between 50–100×109/L; Group II, 10–50×109/L; and Group III, <10×109/L. All patients were treated for their primary diseases for different periods.

RESULTS: Before the termination, in Group I there was 1 patient (33%) receiving platelet transfusion. The platelet count increase index (CCI) was 4.5×109/L; there were 3 patients (50%) receiving prednisone, and their platelet count increased daily by 27.5×109/L on aver­ age; and there were 2 patients (33.3%) who did not receive either of the 2 treatments above. In Group II 6 patients (85.8%) received a platelet transfusion. The CCI was 14.1 × 109/L, 1 patient (14.2%) received pred­nisone therapy, and the platelet count increased by 24.9×109/L daily on average; in Group III there were 2 patients receiving both platelet transfusions and prednisone therapy. The CCI was 44.7×109/L; 2 patients received only platelet transfusion treatment, and the CCI was 39.3×109/L. All 17 patients had a successful pregnancy termination, 100% retained their uterus, and the rate of uterine ar­tery embolization was 10% (2 patients from Group III).

CONCLUSION: When ter­minating a second trimester pregnancy affected by throm­bocytopenia, platelet trans­ fusions and prednisone are commonly used and effective methods, but the combina­tion of the 2 is more effective, especially for critical cases.
Keywords:  abortion, gestational thrombocytopenia, methods, prednisone, pregnancy termination, second trimester, thrombocytopenia
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