| Gestational | • Isolated, mild (100,000-150,000/mm3) • Asymptomatic • Diagnosis of exclusion | | --- | --- | | Preeclampsia with severe features/HELLP syndrome | • Moderate to severe (<100,000/mm3) • Hypertension ± headache/scotomata • ± ↑ Creatinine, ↑ AST & ALT | | Immune-mediated thrombocytopenia (ITP) | • Isolated, moderate to severe (<100,000/mm3) • Asymptomatic or mucosal bleeding/bruising • Normal PT, aPTT | | Thrombotic thrombocytopenic purpura (TTP) | • Severe (<30,000/mm3) • Neurologic symptoms (eg, confusion, seizure), fever, abdominal pain, petechiae • Normal PT, aPTT | | Disseminated intravascular coagulopathy (DIC) | • Moderate to severe (<100,000/mm3) • Bleeding (eg, oozing intravenous sites) ± thrombosis |
Idiopathic thrombocytopenic purpura, which is approximately tenfold more common in pregnant women than in the general population, usually presents with mild thrombocytopenia. Patients are often asymptomatic and have no history of bleeding disorder.