gestational thrombocytopenia

jstrat53

Hi ladies.  I am moving over from 2nd tri board.  I just found out this morning that I have gestational thrombocytopenia and wondering if anybody on the board has any experience.  It is a blood condition that causes low platelet counts which can cause problems during labor if your blood doesn't clot.  My count was 139 when I had my blood draw on saturday.  Which I guess isn't that bad but still below normal (normal being btwn 150-400).  Doc wants to retest at 32 weeks and see if it continues to drop. In my google'ing, it sounds like it isn't really much of a problem unless it drops really low, like under 100.  In that case maybe some steroid meds and possible not being allowed to have an epi! 

phdprocrastinator

I had it with DD and may be on my way again with #2 (last blood draw was just under 140k).  

With DD, I had some additional monitoring blood draws.  When I got to under 100k (just before labor), my NP had me get a coagulation test.  From what I understand, if your numbers are between 50k-100k, they can do a coagulation test to determine whether or not you can have an epidural.  Under 50k and you're out of luck as the risk of bleeding into your spine is too high.  

My coag test came back perfect the day before labor.  The day of labor, I think they tested my platelets and coagulation numbers again.  (I'm a bit hazy here as I had a fentinol(?) shot after being admitted and was basically unconscious for 3 hours until they came in with the epidural - in part due to the meds and in part due to laboring through the night so I was exhausted.  They definitely tested my platelets again).  

I was eligible for the epidural - and was having back labor - so I went for it.  Then, they repeated the tests before I was able to have my epidural catheter removed.  My numbers dropped to the 70k's by the end of labor, so I had the epi catheter in for about 24 hours until the numbers started rising. 

I think having the catheter in for so long did lead to some prolonged back pain/stiffness compared to others I've spoken with about it.  But that went away by 4-6 months.  It wasn't too bad, just that a certain point on my back got stiff if I slept in the same position for too long.  Nothing to make be reconsider having an epi again if I'm eligible again.

I am reading up on non-medicated child birth this time around, just in case!  I kind of blew it off last time, but at the last moment it seemed like there was a real chance of not getting the epi and I didn't feel prepared.  So, I'd recommend looking into that now so you're not panicking in the last weeks.

Best of luck to you!

Stategrl522

I had this with my daughter two years ago and had already planned to go for an unmedicated labor/delivery beforehand but was shocked to find out I did not have a choice in the matter when my platelet count came back at 89. With this pregnancy my doctor has been keeping tabs on my count and so far has been around 90 to 103 so as we get closer they may give me something to bump them up. I am planning on not having an epidural with this birth as I am figure if I did it once I can do it again:) I also had post natal hemorrhaging so that is my biggest concern in the case the low platelets were a factor in that.

jstrat53

I know my numbers aren't that bad (yet at least) but I am going to plan at this point to not have epidural.  I was on the fence anyway, I actually just had a discussion with my doc at my last appointment about not having it due to a horrible experience last time.  

It is just scary to find problems during pregnancy.  I know there are a lot of women out there who have dealt with this and had no concerns but it just scary cause I have never heard of it before.