DOI: https://doi.org/10.36347/sasjm.2026.v12i07.002

Pages: 710-715

Thrombocytopenia is a frequent hematological abnormality during pregnancy, resulting from physiological adaptations or pathological conditions affecting platelet production or destruction, and its accurate evaluation is essential for optimal maternal and fetal management. This prospective descriptive study, conducted at the Mohammed VI University Hospital of Marrakech, included 100 hospitalized pregnant or postpartum women with hematological abnormalities, among whom 49 presented with thrombocytopenia. The aim was to assess the etiological profile of gestational thrombocytopenia and the contribution of advanced automated platelet parameters. Complete blood counts were performed using the Sysmex XN-3100 analyzer, combining impedance and fluorescence platelet counting (PLT-F) as well as immature platelet fraction (IPF) measurement. Thrombocytopenia was predominantly observed in the third trimester and mainly associated with HELLP syndrome and severe preeclampsia. Fluorescence platelet counts were consistently higher than impedance counts, leading to reclassification of platelet levels in several patients and reducing unnecessary diagnostic investigations. The IPF was significantly elevated in thrombocytopenic patients (mean 12.25%), particularly in HELLP syndrome, acute fatty liver of pregnancy, and immune thrombocytopenic purpura, reflecting increased bone marrow platelet production and compensatory thrombopoietic activity. Peripheral blood smear examination provided complementary morphological information, including schistocytes, anisopoikilocytosis, and macroplatelets, supporting etiological orientation. Overall, the integration of fluorescence platelet counting and IPF into routine obstetric practice enhances diagnostic accuracy and supports more appropriate clinical decision-making in the management of thrombocytopenia during pregnancy.