title: Hepatitis C virus-associated thrombocytopenia in pregnancy: impact upon multidisciplinary care provision.
abstract: OBJECTIVE
  Recent studies have implicated hepatitis C virus (HCV) in the pathogenesis of immune thrombocytopenia. In pregnancy-associated immune thrombocytopenia, multidisciplinary management is required due to a potential for bleeding complications. We performed a retrospective review of HCV-infected pregnant women and age-matched controls who were not infected with HCV.
  
  
  METHODS
  One hundred and six women with a HCV viral load were identified from 2009 to 2011.
  
  
  RESULTS
  Thrombocytopenia was identified in 10.3% of HCV-infected pregnant women and 1.6% of age-matched controls (P<0.001). Mean platelet count during pregnancy was 120 ± 23 × 109/L in HCV-infected women and at delivery was significantly lower in HCV-infected women than in controls (P=0.01). Despite the significant difference in platelet counts, there was no significant difference in estimated blood loss (EBL) at delivery. Regional anaesthesia was performed in 73% of thrombocytopenic HCV-infected women and no complications were recorded. There were no fetal bleeding complications.
  
  
  CONCLUSIONS
  In the first study to date to investigate the impact of HCV on maternal platelet count we demonstrated a significantly higher frequency of thrombocytopenia and a significantly lower platelet count in HCV-infected pregnant women compared with controls. Interestingly, thrombocytopenia had no detectable impact on EBL at delivery.
authors.forename: Cathy
authors.initials: C
authors.lastname: Monteith
authors.forename: Fionnuala
authors.initials: F
authors.lastname: Ní Áinle
authors.forename: Sharon
authors.initials: S
authors.lastname: Cooley
authors.forename: John S
authors.initials: JS
authors.lastname: Lambert
authors.forename: Barry
authors.initials: B
authors.lastname: Kelleher
authors.forename: Valerie
authors.initials: V
authors.lastname: Jackson
authors.forename: Maeve
authors.initials: M
authors.lastname: Eogan
mesh_terms: D001803:Blood Transfusion; D016022:Case-Control Studies; D005260:Female; D019698:Hepatitis C, Chronic / Q000097:blood*; D006801:Humans; D015994:Incidence; D033183:Interdisciplinary Communication; D018743:Perinatal Care / Q000458:organization & administration; D010976:Platelet Count; D006473:Postpartum Hemorrhage / Q000209:etiology* / Q000517:prevention & control / Q000628:therapy; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000453:epidemiology / Q000276:immunology / Q000628:therapy / Q000821:virology*; D011251:Pregnancy Complications, Infectious / Q000097:blood*; D012189:Retrospective Studies; D013921:Thrombocytopenia / Q000453:epidemiology / Q000276:immunology / Q000628:therapy / Q000821:virology*; D019562:Viral Load