Introduction: Thrombocytopenia is one of the common hematological disorders during pregnancy, which can increase the risk of postpartum hemorrhage and the need for transfusion. This study aimed to investigate the frequency of blood product transfusion in women with low platelet counts undergoing cesarean section and its association with the severity of preoperative thrombocytopenia.
Methods: This retrospective cohort study (based on medical records) was conducted on 212 pregnant women with thrombocytopenia who underwent cesarean section at Kosar Comprehensive Women's Hospital in Urmia in 2024. Patients were divided into three groups based on preoperative platelet count (exposure): mild (n=111), moderate (n=91), and severe (n=10) thrombocytopenia. Demographic, obstetric, and laboratory data, as well as the amount of blood products received (platelets, packed red blood cells, and fresh frozen plasma) and intraoperative estimated blood loss, were extracted from the patients' medical records. Data were analyzed using ANOVA, Kruskal-Wallis, chi-square, and Fisher's exact tests.
Results: The mean age of patients was 30.67 years. Baseline demographic and laboratory characteristics were comparable among the three groups. The need for blood product transfusion increased significantly with the severity of thrombocytopenia. Patients with severe thrombocytopenia had a significantly higher requirement for platelets, packed red blood cells, and fresh frozen plasma compared with those with mild and moderate thrombocytopenia. Estimated blood loss was also significantly greater in patients with severe thrombocytopenia.
Conclusion: The severity of preoperative thrombocytopenia can be a predictive factor for the need for blood product transfusion in cesarean section. Severe thrombocytopenia is associated with a high rate of requirement for platelets, red blood cells, and fresh frozen plasma. Proactive blood bank preparedness and meticulous preoperative planning are essential for these patients.