The Effect of Thrombocytopenia in Patients with Chronic Hypertension and Pregnant Women with Hypertensive Disorders of Pregnancy during Dental Surgical Procedures
Background: An important challenge is the fast increase in the incidence of hypertension
because its management still have challenges, one of which is uncontrolled bleeding
during dental surgical procedures like tooth extraction which may cause by
thrombocytopenia as it can be a complication of hypertension. Dentists treat a large
number of patients with bleeding problems in the dental setting so dental professionals
need to conduct detailed clinical assessments and communicate with the patient’s
physician to develop suitable planning strategies to treat such patients.
Objective: This study was done to shade a light about the risk of thrombocytopenia in
patient with chronic hypertension and pregnant women diagnosed with gestational
hypertension and preeclampsia who they need dental surgical procedure.
Methods: Cross-sectional study was conducted in a period from the 1st of January 2014
to the 1st of January 2016 in the dental clinics of college of dentistry, Al-Anbar University
and Al-Amiriya health center, Baghdad. The study included 250 participant divided into
four groups: Group 1 included 50 patients divided into 32 chronic hypertensive men and
18 women. Group 2 included 85 pregnant females with gestational hypertension. Group 3
involved 65 pregnant females with preeclampsia. Group 4 involved 50 healthy controls. A
verbal consent was taken from all participants before the start of the study. All participants
had a thorough history and subjected to clinical examination involving measurement of
blood pressure and examination of eyes fundi. Laboratory investigation was done and
involved the following: complete blood picture, blood film, Albumin; platelet count (Plt),
liver and renal function tests. Platelet counts had been estimated in EDTA anticoagulated
blood. All patients with thrombocytopenia referred to their physician for proper
management before any surgical intervention.
Results: The incidence of thrombocytopenia in chronic hypertensive patients was 12%.
The incidence of hypertensive disorders in pregnancy was divided into (18.8%) for
gestational hypertension and (44.6%) for pre-eclampsia. The total incidence of
thrombocytopenia in whole studied population was (25.5%). All patients in control group
had normal platelet count.
Conclusion: Thrombocytopenia not infrequently happens as a consequence of
hypertension and may significantly contribute to morbidity due to excessive bleeding.
Platelet count is very important in suspecting a deranged coagulation state early in
hypertensive disorders and helps plan management strategies in reducing the risk of
bleeding in dental surgical procedures.
Keywords: Hypertension, Thrombocytopenia, Pregnancy induced hypertension.
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