Prospective Study of Maternal and Perinatal Outcome in Pregnant Mothers with Bleeding Disorders in Tertiary Care Hospital

Abstract

Background: Obstetrical bleeding disorder presents difficulties for both the mother and her offspring. Bleeding disorders, both congenital and acquired, may have deleterious effects on the fetus as well as newborns. In addition they may pose serious complications during pregnancy, parturition and postpartum period. Women who have congenital bleeding disorders and   are carriers of X-linked or autosomal disorders, should compulsorily receive counselling to ensure that pregnancy can be carried out safely and with the utmost care. In such cases, Obstetrician, Hematologist and Anaesthesiologist should work together to create a treatment plan. The mother should be closely monitored throughout pregnancy, delivery and in puerperium. Pregnancy related acquired hemostasis disorders may be particularly difficult to diagnose and need to be treated right away. Methodology: Pregnant women with a history of bleeding disorder or newly diagnosed by investigations who will give consent to participate will undergo various investigations.Various Investigations will be done related to both congenital and acquired bleeding disorders which are given as under: 1) Complete Blood Count 2) Peripheral Blood Smear 3) Reticulocyte Count 4) Coagulation Profile 5) Renal Function Test 6) Liver Function Test 7) Thyroid Function Tests 8) USG Whole abdomen and pelvis The data will be obtained and statistical analysis will be done by using appropriate formula.  Results: The study was conducted on Pregnant Women with a history of bleeding disorder or newly diagnosed by investigations who gave consent to participate in the study presented to the OPD or IPD of Department of Obstetrics and Gynaecology, MTH hospital and MY hospital Indore. A total 150 pregnant women were included as per the inclusion criteria of our study. From the study, majority of cases had gestational thrombocytopenia (78%), 86% of them were free from maternal complications and 80.6% of them had no perinatal complications. Conclusion: It is essential that strict monitoring of pregnant women to be done to understand the risk behind maternal morbidity and mortality. Early diagnosis and scans to understand the warning symptoms during the intrapartum and postpartum periods is essential.