Hepatitis C virus (HCV) is associated with massive worldwide morbidity and mortality. Recent studies have implicated HCV in pathogenesis of immune thrombocytopenia.1 ,2 However, the impact in pregnancy has not been explored in detail.
We looked at the impact of HCV on maternal platelet count, bleeding and multidisciplinary management of labour and delivery in a retrospective series of HCV-infected pregnant women. Women with a detectable HCV viral load were identified between 2009 and 2011. Platelet count and HCV viral load were determined at booking, 32/40 and delivery in HCV-infected women and controls.
Thrombocytopenia was identified in 10.3% of HCV-infected pregnant women in comparison to only 2.1% of age-matched controls (p < 0.01). Mean platelet count at delivery was significantly lower in HCV-infected women compared with controls (p = 0.01). There was no significant difference in estimated blood loss (EBL) at delivery. Regional anaesthesia was performed in 73% of thrombocytopenic HCV-infected women.
In the first study to date to investigate the impact of thrombocytopenia upon pregnancy management in HCV-infected women. We demonstrated a significantly higher frequency of thrombocytopenia and a significantly lower platelet count in HCV-infected pregnant women compared with controls. We recorded no significant fetal bleeding complications.
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