Low Platelets

allisonlopes

I was hesitant to post because I don't want anyone to freak me out more than I already am, but has anyone had experience with low platelets? I am 38 weeks, and the last time I was checked they were at 74,000 which is low. I had a very fast labor with DS, so I'm not worried about not being able to have an epidural. Just wondering if anyone out there was low when their LO was born. 

mrsjengle

74K is very low. Did they say if they were going to do anything to treat it? I'd be concerned about going into labor with numbers that low. Mine made it down to 81k, and I was freaking out. There are a few conditions that can cause that in a pregnancy. Maybe just ask why they think your number is so low.

allisonlopes

Thrombocytopenia...I had it with my DS, but was living in a different state and my Dr. didn't really seem to make a big deal about it. This Dr. sent me to see a hematologist. I actually have GD, too, and I was told by the hematologist that if my platelets went too low they would put me on prednisone for a week...but that makes your blood sugar go crazy apparently. I'm going for monthly ultrasounds for the GD, too. 

allisonlopes

did you deliver at 81,000?

mrsjengle

allisonlopes:

did you deliver at 81,000?

No, I'm only 34 weeks now. I have a bunch of crappy crap going on. That is just one thing I'm dealing with. They were worried about HELLP syndrome with me, but ruled that out. Right now I think we are looking at a Cholestasis diagnosis. But, when I was in the hospital with a count of 81k, the OB was very concerned about what would happen if he had to deliver me because of HELLP.

Kadyra

Between 50-150k platelets, it's called gestational thrombocytopenia. And it's benign. You just can't have an epidural below 100k. If it happens in one pregnancy, it tends to happen in future ones. There's no increased risk of bleeding in labor or after. If it doesn't go up to normal in between pregnAncies, it's common to see a hematologist, but they don't usually offer any insight. 

When platelets drop below 50k, you start To think about ITP, which they think is caused by platelet antibodies. That's when you start worrying about increased bleeding risks in labor. I'd this is the case, you'll definitely see heme and be started on prednisone and/or IVIg. If it persists after pregnancy, you may need a splenectomy and a bone narrow biopsy. 

You sound like the former, but if you have specific questions, ask your doc  

allisonlopes

Kadyra:

Between 50-150k platelets, it's called gestational thrombocytopenia. And it's benign. You just can't have an epidural below 100k. If it happens in one pregnancy, it tends to happen in future ones. There's no increased risk of bleeding in labor or after. If it doesn't go up to normal in between pregnAncies, it's common to see a hematologist, but they don't usually offer any insight. 

When platelets drop below 50k, you start To think about ITP, which they think is caused by platelet antibodies. That's when you start worrying about increased bleeding risks in labor. I'd this is the case, you'll definitely see heme and be started on prednisone and/or IVIg. If it persists after pregnancy, you may need a splenectomy and a bone narrow biopsy. 

You sound like the former, but if you have specific questions, ask your doc  

 

Thanks!! 

ctsportsfan23

74K is not that low.  Your OB should look into the cause but do not freak out.

They should check the baby's platelet count after birth.

The range for epidurals varies depending on your institution.  We do them at >50K where I work. 

 Good luck.

 

PotomacSt

I've had ITP for years and I can vouch for the fact that they generally won't consider treatment until you're below 50K, and even then, will often take the approach of "wait and see" with careful monitoring for anyone between 30K and 50K. You're not in danger of bleeding out until you're below 10K.

Getting steroids is also no big deal, it's generally just a precaution that they throw in because getting just a couple big doses of prednisone has minimal risks.

Also, moms with gestational thrombocytopenia rarely have babies with low platelets, and there's almost zero chance of having a baby with severely low platelets. 

rockonbeurself

I was induced at 37 weeks due to low blood platelets and high blood pressure. Having the baby fixed the problem.

allisonlopes

Thanks, ladies! Definitely makes me feel better. The hematologist really wasn't too concerned, but the nurse from my doctor's office was really rude and made me feel like it was worse than it is. I have my next platelet reading on Friday, so fingers crossed!