Certain drugs administered to pregnant women have been reported to cause thrombocytopenia in woman and in their fetus and newborn. However, it is difficult to statistically differentiate apparent association between drug ingestion and development of thrombocytopenia in a given case. Mechanisms by which drug produce idiosyncratic thrombocytopenia in mother and fetus is unclear, but may involve immune reaction. Antibodies are formed against drug HEPTRAN complex that cross-reacts with a platelet antigen. When such antibodies are IgG type, in addition to getting attached to maternal platelet, it crosses placenta and simultaneously attach to fetal platelets. The drugs that have been implicated are quinine, thiazides, diuretics, hydralazine, tolbutamide, indomethacin, heparin, vancomycin and intravenous lipid infusion.

Drugs given to neonate like aspirin, phenylbutazone, promethazine, indomethacin, carbenicillin, etc. have all been shown to produce platelet dysfunction presumably by inhibiting cyclo-oxygenase enzyme. Though these disorders usually lead to minor bleeds and do not require any active treatment, in emergency, after injury or before operation they may have to be given platelet concentration judiciously.

Miscellaneous causes of thrombocytopenia include :-

• Caused by thrombosis like renal vein thrombosis, NEC (narcotizing enterocolitis), other vascular thrombosis.
• Intrauterine growth retardation
• Pregnancy induced hypertension
• Perinatal asphyxia
• Idiopathic

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