Reactive thrombocytosis after caesarean section and normal vaginal delivery: Implications for maternal thromboembolism and its prevention
Dr. Suha Abduljaleel Wadi, Dr. Ahmed Rifat Shakr, Dr. Farah Muayyed Gebriel Shammas Youisif
Objective: To assess the duration and severity of reactive thrombocytosis after caesarean section and after normal vaginal delivery. Design: A prospective study. Setting: Al-Elwiya Maternity Teaching Hospital -Baghdad -Iraq. Materials and Methods: Seventy pregnant women who were admitted for delivery at Al-Elwiaya Maternity Teaching Hospital were recruited into the study, the platelets count was measured at the time of first visit in the antenatal period. The second sample was taken just before normal vaginal delivery or caesarean section, followed by postnatal blood samples on days: 3, 8, 12, 16, 20 and 24 for the measurement of platelets count. Seventy pregnant women were recruited and forty completed the study, twenty of whom were delivered by normal vaginal delivery and twenty by caesarean section. This study compared the platelets counts within and between the two groups (normal vaginal deliveries group and caesarean sections group) to assess the severity and timing of reactive thrombocytosis. Results: Antenatally: there were no statistically significant differences in platelets count measurement in the first antenatal visit and the pre delivery visit between the two groups. There was a slight fall in the pre-delivery platelets count in both groups compared with first visit platelets count but this fall was not significant. Postnatally: I. in the normal vaginal deliveries group; the platelets count continued to fall until the third postnatal day, then it rose, reaching peak values, compared with first visit and pre-delivery values at days 8 and 12 of the postnatal period which was statistically significant. The mean platelets count decreased gradually thereafter. II. In the caesarean sections group; the platelets count gradually increased, the rise started from the third post-operative day reaching a significantly high value, compared with first visit and pre-delivery values at day 8 of the postnatal period. The platelets count peaked at days 12 and 16 of the postnatal period. The platelets counts remained significantly higher than the first visit and pre-delivery values for 24 days after the caesarean section.