Low platelet count ?

AshleyMaureen

has anyone else had low platelets ? I'm a little over 32 weeks and my platelets keep dropping . I'm getting worried it's associated with preeclampsia but wondering if anyone else has had this happen and what they did !?

Wering

How funny you posted this. It's been on my mind all day. My count is at 107, I guess, which isn't good (but not horrid). So far the doctor has told me that he wants to get them up or else I won't be eligible for an epidural (I don't want one anyway, but if I end up with a C/S, It'd have to be under general which I def. do not want) if they don't go up. I'm scheduled to see a hematologist next week. 

I'd be interested to hear if anyone else has had the issue.

astrat017

I saw a specialist for this in my first pregnancy. Told me if they didn't go up on their own that we could try a steroid treatment. I never had to but worth asking your Dr about

AshleyMaureen

Mine we're at 117 then 107 then 98 this last time . That's what they told me also about the epidural and the c/s. They don't seem to be to worried but the more I read about the more worried I am getting ! They say it happens with preeclampsia and can be severe . They had me do a consult with a anestisiologist but that's it so far . It doesn't seem to be to common so that is what scares me and they said there was nothing they could do to get them up either .

Wering

@AshleyMaureen - after I see the hematologist next week, I'll let you know what he says. See if its something you can ask your doctor about. I'm choosing not to get myself into a tizzy because my Dr. doesn't seem to be freaking out about it.

beep6610

I also have low platelets. They dropped from 125 to 118 in 2 weeks, so my doctors sent me to the hematologist. The hematologist told me that I shouldn't be walking out of the office freaking out, because at this point they still aren't that low. What's important is that your doctor continues to monitor the levels so they have that knowledge of what they are when going in for delivery.

I was told that if they do get too low, they'll put me on steroids at 37 weeks. He also said that it varies by anesthesiologists what level they'll still give the epi at. Some will do it at 100 lowest, some will do it at 80 lowest.

Take a deep breath, come up with some questions for your doctor, and stay off the google!

beep6610

I should mention, he said they wouldn't consider even putting me on steroids unless I was around 30-40.

Louise_Belcher

I have been dealing with this issue since my first tri with a cbc done every month (platelet count keeps dropping) and hematologist appointments every other month. They diagnosed me with ITP, so mine is not gestational or caused by preeclampsia (BP is healthy, low, and consistent). I have tested under 100 for the last few months, so unless it pops back up on its own or they intervene at the end I am losing hope of getting medicine (not thrilled about that but I will deal). After the initial panel of blood tests it just seems to be a waiting game until the big day or the days leading up to it. In my situation, the hematologist informed the OB that they will not be able to use a internal fetal monitor (the little screw thing that goes in the baby's head), forceps, or vacuum. Also a circumcision will need to be delayed for a few days until it is confirmed that the baby is not (or no longer is) effected by my antibodies that are causing the issue. 

My dr's do not seem overly concerned either, but cautious with monitoring. 

Wering

I just saw the hematologist regarding my count. On June 23, I was 107. On June 25 I was 119. On July 1 I was 128. Which is weird, because when my blood count was done originally, I was 137. So they've been up and down. He said that they really only worry when they're below 50,000. There are different ranges for different things. For example - an epidural requires a count of 80-100. Brain surgery requires 100+. You won't be spontaneously bleeding or seeing adverse affects until your count is 10 or 20. 

I'm glad he says nothing to worry about; was very concerned about being put under general should I need a csection. We're going to monitor it every 2 weeks until delivery just to make sure they stay in a safe range. He did say that if they start to drop, we'll probably use steroids to bring it up. Same steroids they'd give for early delivery to stimulate lung development, so its safe for me and baby. They need 48 hours to work, so we'd have to do it in advance of delivery.

His one word of caution is that low platelets (lower than 100) tend to go hand in hand with toxemia - so if I notice swelling, high blood pressure, protein in urine, etc., I should be seen right away.

Hope you ladies are getting answers specific to your own situation!

Sbuxtonteaches

So weird how there are so many different points of view. I feel like my doctor made me a bit more nervous. My count dropped to 74 and I was told if we can't get it up (csection in a week and a half) they will have to give me general anesthesia. I'm not looking forward to the side effects of the prednisone though! More weight gain, swelling, hypertension and indigestion!!!! But baby needs another week to bake. So I'm doing what I'm being told!!!!

Bailey1823A

Wering said:

I just saw the hematologist regarding my count. On June 23, I was 107. On June 25 I was 119. On July 1 I was 128. Which is weird, because when my blood count was done originally, I was 137. So they've been up and down. He said that they really only worry when they're below 50,000. There are different ranges for different things. For example - an epidural requires a count of 80-100. Brain surgery requires 100+. You won't be spontaneously bleeding or seeing adverse affects until your count is 10 or 20. 

I'm glad he says nothing to worry about; was very concerned about being put under general should I need a csection. We're going to monitor it every 2 weeks until delivery just to make sure they stay in a safe range. He did say that if they start to drop, we'll probably use steroids to bring it up. Same steroids they'd give for early delivery to stimulate lung development, so its safe for me and baby. They need 48 hours to work, so we'd have to do it in advance of delivery.

His one word of caution is that low platelets (lower than 100) tend to go hand in hand with toxemia - so if I notice swelling, high blood pressure, protein in urine, etc., I should be seen right away.

Hope you ladies are getting answers specific to your own situation!

If your hematologist said they can place an epidural or spinal with a count between 80-100 without consulting an anesthesiologist I would consider talking to one before making this generalization. There are so many subspecialties in medicine and from my experience as an L&D RN, there are very few anesthesiologists that will place an epidural/spinal with platelets less than 90 and even that is being conservative. Even more wont if less than 100. Also there can be significant blood loss with either a vaginal delivery but especially a c/s and low platelets can be an issue with clotting. So in theory you could be symptomatic before your platelets are that low as well as suffer adverse effects. I don't want to scare anyone but this is why Drs consult each other. Each knows something specific about his or her speciality but I wouldn't take a blanket statement made by one as face value. Sorry for being blunt.

mtxo

Thanks for sharing girls. I got my results yesterday 104, and seeing the Dr. tomorrow to see what he says. Due date 8/6. Hope it stays up.

SerenityDN

Hi all, thought I'd share my experience so far as well... I also was found to have low platelets about a month ago (they were 114, then 119 a week later).  They didn't say much except that I may need to see a hematologist if they drop further.  They did another CBC at my last check-up a couple days ago (36 weeks) and I was down to 78.  Now they seem a bit more concerned and are retesting tomorrow morning.  I also would like to avoid steroids due to the side effects - it can also worsen insomnia and I've already only been getting a few hours a night.  They actually haven't yet told me anything about how this can/will affect delivery... perhaps they're waiting until closer to the due date to discuss?  

I've been tested for pre-e, but have remained negative and all my other bloodwork is fine.  I'm diagnosed with gestational thrombocytopenia at the moment.

jlo629

I have ITP for years now which is a low platelet disorder and I had to get a ton of steroid treatments over a few years. I get my platelets tested every 2 weeks and the babe will be tested right after birth as well. Basically you are not at risk unless you are below 50, unless you need surgery and they have drug options to even make that safe. Hematologist are great and I talked to mine before I tried to get pregnant and he explained that lots of pregnant women have lower platelets due to the large increase in blood your body has to make and your spleen just can't keep up in platelet production. They have normal guidelines and pregnancy guidelines. I don't know if that makes anyone feel better but this is something I know very well and I promise is not by any means the worst.

Wering

If your hematologist said they can place an epidural or spinal with a count between 80-100 without consulting an anesthesiologist I would consider talking to one before making this generalization. There are so many subspecialties in medicine and from my experience as an L&D RN, there are very few anesthesiologists that will place an epidural/spinal with platelets less than 90 and even that is being conservative. Even more wont if less than 100.

@Bailey1823A - Thanks for weighing in on this. My hematologist is associated with the hospital at which I am going to deliver, and he's the "go to" for pregnant women with low platelets. He has a very close association with the anesthesiologists and OBs at the hospital, so I trust that what he was telling me is the truth for that particular hospital. Perhaps I should have clarified.

jenandbrett

I've dealt with low platelets with all three of my pregnancies, but not once blood pressure issues. With my first daughter they got down to 61 when they decided to induce me. Currently they are at 106 and were 95 last week. The trend seems to be for mine to temporarily jump at 36 weeks and then go back down, so I'm expecting lower again next week. I haven't been able to get an epidural with any of my babies but honestly after not having a choice with my first, I'm so grateful. Having a baby med free is amazing. I've heard and read that green leafy veggies, especially spinach can help platelets so I've been trying to load up on them. Maybe that explains why my levels are higher this time, but I can't guarantee that. youll be just fine.

SerenityDN

Great discussion ladies... you don't hear much about platelets issues so it's great to read some similar experiences!

A quick update from me... my platelets are at 88 today and my doc is comfortable that they're relatively stable.  She said no hematologist until it got down into the 60s at which point they'd start to worry it was more than just pregnancy related.  She's also going to make sure the anesthesiologist knows about the issue and tests before an epidural on delivery day.