Mamas with thin blood/ITP/bleeding risk and/or prednisone takers (long)....

tosh24 · September 2011

Hi Ladies!

I've been quietly lurking here and there during my pregnancy but felt I didn't have much to contribute because I'm not "officially" high-risk as of right now.

I have ITP, which is an autoimmune disorder where my body attacks my own blood platelets. Obviously, this leads to a possible bleeding risk. I was aware of my disorder when I was pregnant with my DD, but my OB just monitored my levels weekly and I had a consult with a hematologist. No big deal. My counts were around 87,000 (normal is between 150,000 and 400,000). Uneventful vaginal delivery at 38w5d.

Pregnant with #2 now and have a new OB. He's already talking about putting me on prednisone at 37-ish weeks and possibly inducing labour as soon as my platelets are over 100,000 again. He referred me to another hematologist and I have that consult next week. I also had a borderline-low PAPP-A score, so they are monitoring baby and my placenta with ultrasounds and NSTs. If it becomes an issue, we may be talking c-section. I was totally caught offf guard yesterday when he started mentioning all this intervention, as I didn't have any of it with my last pregnancy, and my platelets this time around are about the same count (82,000). I'll suck it up and take the prednisone I think, because in the event of a c-section I'd rather not have to deal with being a bleeding risk, but all the other "just in case" intervention he's springing on me, I'm not really down with. One of his main arguments is that if my platelets are below 100,000, I can't get an epidural. I already know this because of my last delivery, and have been planning for a natural birth. Not being able to get an epidural is not really a strong argument in favour of all the intervention he's talking about (IMO).

Any ladies with experience in the thin blood/ITP world? What are your doctors recommending as a plan of action? Anyone taking prednisone? What are the side effects like?

Thanks, ladies. My head is spinning today.

papillon21 · September 2011

My experience is completely different, I?m on prednisone because my hands and feet keep swelling up for no apparent reason?.that they can find. It is suppose to suppress my immune system in order for swelling to no happen or to be minimized. I?ve been on it for 2 weeks now. The only side effect for now is that I feel slow for the first 2 hours when I take in the morning with a light breakfast (like cereal). If I take it with something more consistent (bagel, ham, egg and cheese and milk) I don?t feel anything.

Sorry, I don?t have anymore input.

mandarod · September 2011

I have ITP but my numbers are hovering around 100-107 right now. I had to be put on prednisone with dd at 38 weeks because they dipped to 59, but I was induced one week later at exactly 39w when they had gotten back to above 100. I had a normal vag delivery with an epidural.

I didn't know what to ask last time or know much about ITP because I hadn't officially been diagnosed yet - the issue was discovered during my pregnancy since I had never had any issues/testing done before.

This time, I have also switched OBs, and to make things fun, my new OB is now leaving the practice, and I'll be seeing her partner, whom I've never even met. : I did see an MFM for my 20 week a/s, and he also mentioned the "magic" number for the epi to be at 100. He is not too concerned about me now because I've been consistently around 100 and responded well to steroids last time, but if I do drop again later on, he'll recommend prednisone.

I'm not sure what to think quite yet, because I got a second opinion after my official diagnosis from the Head of Hematology at a top local hospital who said he wouldn't be so quick to recommend steroids. Soooo, I don't know. I haven't seen the hematologist yet during this pregnancy - I probably won't until my levels drop below 100, but we'll sort it all out soon. I'm not against taking prednisone again, but I don't want to if I don't have to.

The prednisone wasn't too bad when I took it. I had some sleepless nights that first week, and, although I dropped the baby weight quickly, I still had the puffy "steroid face" for a few months. You have to wean off of the drug and can't just stop taking it. My sister has to take it every now and then for a digestive disease she has, and she has worse reactions to it.

Good luck and hang in there. I'm sure everything will work out just fine for you!

mandarod · September 2011

Also, if you're below 100 and can't have an epi (and they're doing a c/s), that may mean they want to put you under general anesthesia. That came up when all my issues came to light during the end of my pregnancy with dd.

tosh24 · September 2011

Thanks, ladies!

As of right now, my doctor has only suggested 10 days of prednisone. Once my platelets jump back up, they want to induce. If they're still hovering in the 80-100 range, I'm not too worried about being a bleeding risk because the counts are that low, and I think I would attempt to put off the induction and forgo an epi. There are other pain management options should I feel I need something.

The reason why I'm agreeing to take the prednisone is because of the possibility of c-section in my situation. Like the PP mentioned, I'd have to be put under GA and I don't want to give birth that way (and there's also increased risk with GA, so I'd rather take the prednisone so that I'd be able to get a spinal for a c-section).

Thanks for the insight into the prednisone. I've heard some not-so-nice things about it so I was just worried!

Katelobster · September 2011

Hi,

I have no advice but just wanted to say good luck. I was diagnosed with ITP two years ago when I was at 50,000 but have never needed treatment and was at 100,000 last time it was checked.

Thanks for posting this. I definitely have a lot to learn...

Mamas with thin blood/ITP/bleeding risk and/or prednisone takers (long)....

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