Low platelet count

lke17

I found out around week 8 of pregnancy that my platelet counts were low. I've been going to a hematologist to monitor them and they have been consistently dropping about 10 million every time I get my blood checked. Last time was 128 million. I'm 21 weeks along and I'm afraid by the time I get close to delivery they will be extremely low and I may not be able to have a natural delivery. Well meaning no epidural and potential c-section. I've read however sometimes it's worse to have a c-section with low platelets because you lose more blood. The doctor does not have me on any medication for it but my OB put me on an iron supplement because I'm borderline anemic. Does anyone have any experience with this?

drowe214

Yes. With my son I had low platelets at 9weeks (124mil) went to a hematologist and there were no under lying issues, just pregnancy related. At about 36 weeks they were around 80mil so they put me on pregnasone (sp) to boost them, but 4 days later I had pre-eclampsia so I ended up with an emergency c-section under general anesthesia (basically worse case scenario). If the steroids had worked, they would have induced me while they were at the right level so I could try vaginally. One thing that helped is that my doctor set me up with an anesthesiology apt near the end so I knew what my options were and knew what to expect. It depends on the hospital but you can still have an epidural or spinal around 100mil. This time they are low again but bc of the prior c-section they can't induce so I probably won't try the steroids again. Need to set up an apt with the hematologist soon. I think the bottom line is be flexible, trust your doctor, and know that in this age of medicine it will all work out. It was not what I planned At All! But at the end of the day I have a beautiful son and am doing it again!

marisolnunez87

It happens to a lot of pregnant women because the higher blood concentration needed. You won't need meds unless they drop below 100k. Mild pregnancy thrombocytopenia. Just make sure it's not a health issue you were aware of like itp, which I have, an autoimmune disorders where your spleen kills platelets. Just be careful to prevent injuries and take your iron. I recommend floradix tablets. Gentle on the tummy. Prayers

lke17

Thank you ladies!

jasbaby2

I have Itp when not pregnant and right now my platelets are about 124 and I see a hematologist as well.

With our son mine got as low as 70 and when I got to the hospital for delivery they were around 90. I believe I started iron at some point last pregnancy as well. I'm fine, our son is six and healthy, and this has never caused any problems for me. If you have any other questions I'm happy to help

lke17

Thank you! I think my biggest fear is my count going too low around delivery, I'd prefer a vaginal birth and most likely with an epidural but I'm going to see how I feel. I just have fears of bleeding out or needing a blood transfusion. I hope my iron supplement helps keep my platelets up!

Caffrey54

I'm 21 weeks and I just had an appt on Monday with hemo because my platelets are low, and they always have been. I was told I have ITP. The last count they did I was at 113 and was told I don't really have to worry about it until it get to 80. If it gets that low there are a couple different meds I can do to get them up. I had my OB appt on Tuesday and he told me that if I get to 75 I can't have an epidural and they'll hand me a bullet to chew on instead, so we are trying not to let it get that low. Luckily we are having a boy and I guess boys don't get this so he'll never have to deal with it lol.

jasbaby2

leahval said:

Thank you! I think my biggest fear is my count going too low around delivery, I'd prefer a vaginal birth and most likely with an epidural but I'm going to see how I feel. I just have fears of bleeding out or needing a blood transfusion. I hope my iron supplement helps keep my platelets up!

Usually the platelet count has to be 100 to get an epidural but mine were only at 90 and I was able to get one. It depends on the anethesiologist and there will probably be more than one while you are in labor.
It is possible you may not be able to get one.

I wouldn't worry much about the bleeding out or transfusion. My platelets start out low and nothing like that was a real worry.

You didn't mention this but my only other issue was that my ob wouldn't break my water because of the tool they use to do that. The thinking was that since my platelets were low the baby might have the same. It's very flawed reasoning and my hematologist thought it was ridiculous but it was what it was.

ewhitledge

I wouldn't see why they would be quicker to do a section with low platelets over allowing a vaginal delivery without an epidural possibly...If that was something you were considering. OB isn't my specialty though so I have no clue and that's just my critical care nursing thoughts. What I do know is that generally over 100 is not a huge concern and we usually don't even do platelet transfusions until somewhere in the 20s range. I'd say talk to your doc about the possibility of a natural vaginal delivery if that's something you'd be interested in and your platelets continue to drop. The big worry with low platelets is spontaneous bleeding so that's what they have to keep an eye on.

drowe214

leahval said:

Thank you! I think my biggest fear is my count going too low around delivery, I'd prefer a vaginal birth and most likely with an epidural but I'm going to see how I feel. I just have fears of bleeding out or needing a blood transfusion. I hope my iron supplement helps keep my platelets up!

Talk to your Dr but I was told the risk of epidural or spinal with low platelets is hemoraging at the site, not bleeding out from the birth canal.

lke17

jasbaby2 said:

leahval said:

Thank you! I think my biggest fear is my count going too low around delivery, I'd prefer a vaginal birth and most likely with an epidural but I'm going to see how I feel. I just have fears of bleeding out or needing a blood transfusion. I hope my iron supplement helps keep my platelets up!

Usually the platelet count has to be 100 to get an epidural but mine were only at 90 and I was able to get one. It depends on the anethesiologist and there will probably be more than one while you are in labor.
It is possible you may not be able to get one.

I wouldn't worry much about the bleeding out or transfusion. My platelets start out low and nothing like that was a real worry.

You didn't mention this but my only other issue was that my ob wouldn't break my water because of the tool they use to do that. The thinking was that since my platelets were low the baby might have the same. It's very flawed reasoning and my hematologist thought it was ridiculous but it was what it was.

I hadn't heard about them not breaking the water. I guess I just have a ton of questions for my OB! I would definitely prefer to avoid a c-section if I can. I know women have natural (no epidural) all the time but I think I would prefer one, I'm very nervous about birth!

marisolnunez87

The first comment sounds like hellp syndrome since she had the high blood preaaurer too. The ob will probably send you to a pregnancy specialist just as a precaution. Its so reassuring to hear moms that have already felt with the issue. Thanks for asking the question!

tmandato1234

I'm the total opposite. My platlet count is critically high. My ob hasn't mentioned any concerns. It's never been brought to my attention that it could cause something during labor. A doctor did mention that the count could of explained my blood clot after a surgery

kwherry46

I know this is an older post but I just found out that I have a platelet count of 108 which dropped from 125 two weeks ago so I'm getting pretty scared. I'm 31 weeks and my OB just referred me to a hematologist that I'll see next week. I haven't asked my OB many questions yet but should I be worried about the baby? I'm worried about taking prednisone while pregnant if they put me on it. Have any of you taken this and had heathy babies? I haven't had high blood pressure or any other signs of preeclampsia so this is freaking me out.

lke17

I just went to my hematologist yesterday. I'm 30 weeks and my count was at 93. He said he still isn't concerned at all. It doesn't affect the baby and it shouldn't affect mom either. He said he had a patient with a count of 10 and she had a healthy baby and safe delivery. I'm still really worried about it too but he really doesn't seem concerned, he said having gestational diabetes is more of a concern than low platelets. My OB said I might need a steroid by the time I deliver but I think she's saying that so that I can get an epidural since a lot of hospitals won't let you have one if your count is under 100. I'm just preparing myself to not have an epidural and will only take the steroid if in these last 10 weeks it gets dangerously low.

kwherry46

Thank you Ike17. That makes me feel better!

drowe214

@kwherry46 like lke17 said it doesn't really have a health effect on mom or baby but more on what kind of anesthesia you can have. Check with your dr/hospital as at mine as long as I'm over 80 they will do an epidural. At 36weeks with my first they were at 69 and put me on prednisone but unfortunately I had pre-eclampsia 3 days later (not related to the steroids) and so it wasn't real enough time for my platelets to go up and I ended up under general anesthesia which is the worst case scenario. One thing that was helpful though is that incidentally I had a anesthesia consult that morning not knowing I was going to get pre-e and that was really helpful because they went over my options and what would happen in each scenario so I felt more prepared even in an emergency situation. I have low platelets again this time and started out around 112, but my latest count was 136. So I would just say trust your doctor and be flexible as they will fluctuate so you really don't know until game day.

kwherry46

Thank you drowe214. My doctor doesn't seem too concerned about it so I should probably stop stressing about it. Hope those platelet counts keep rising!