THE PLATELET PUZZLE: UNRAVELING THE MYSTERIES OF PREGNANCY COMPLICATIONS

Thrombocytopenia is the second most common hematological disorder encountered during pregnancy, affecting approximately 7 10% of all pregnant women. While gestational thrombocytopenia accounts for the majority of cases, a significant proportion results from pathological conditions such as immune thrombocytopenia (ITP), pre-eclampsia/ HELLP syndrome, and autoimmune diseases, including systemic lupus erythematosus (SLE). Differentiating between these etiologies is crucial, as management and maternal fetal outcomes vary widely depending on the underlying cause.(1)Systemic Lupus Erythematosus (SLE) is a chronic, autoimmune, multisystem disorder characterized by the production of a wide spectrum of autoantibodies against nuclear and cytoplasmic antigens, leading to immune complex formation and widespread tissue damage. It predominantly affects women of reproductive age, with a peak incidence between 15,45 years, and a female-to-male ratio of approximately 9:1 (2).Pregnancy in women with SLE is considered high risk, as it is associated with an increased likelihood of disease flare, obstetric complications, and adverse fetal outcomes. Despite improved disease control and prenatal care, complications such as preeclampsia, preterm delivery, intrauterine growth restriction (IUGR), and fetal loss remain significant (2). The physiological immunologic and hormonal changes during pregnancy can influence disease activity, while active SLE can, in turn, adversely affect placental function and fetal well-being.