Low platelet count

folamij · February 2016

Hi ladies!
I was diagnosed with thrombocytopenia, which is basically I have low platelet counts after being tested several times over the the course of my pregnancy. Because of this my Dr. is sending me to a hematologist for further testing.
Has anyone been diagnosed with this? If so, any advice?

kbrands7 · February 2016

I don't have any advice with this specific diagnosis (my platelets are low, but not quite low enough for a separate diagnosis) but I have been seeing a hematologist to monitor my thalassemia anemia through this pregnancy. My experience with my hematologist is that their main goal is to be able to help you achieve healthy, or healthy-for-you numbers and to explain exactly how low or high areas of the CBC may impact the pregnancy or your own health.

Part of my monitoring has been for low platelet count, as this can go hand-in-hand with what I already have, so I know one of the concerns with low platelets for delivery is bleeding/being slower to clot. I'd imagine that the severity of the platelet count has a lot to do with whether or not this is a true concern. OBs tend to play things on the safe side, so I wouldn't worry-- just be sure to ask your hematologist how your levels are expected to impact your pregnancy (if at all), and if there is anything specific that you can do to help your levels increase.

ayeshaohara · February 2016

As a pharmacist I'm not an expert but I can certainly help shed a little light. Also, I have the opposite....thrombocytosis which is too many platelets. From what I know about thrombocytopenia there are different causes, so that's why you're being sent for further testing. Sometimes pregnancy can sorta unmask or speed up the presentation of a condition you might have already had but not known about. I don't know how TP will affect your pregnancy so be sure to ask what risks are for you and baby, other than the obvious being that you will likely bleed more. Also if you're platelets get to dangerously low levels ask how they treat and if theyll have to induce you, things like that. It will really depend on how low your platelets are and what the cause of the TP is. I like to know so I'm not caught off guard and am prepared for all options.

For example this week I asked if I was going to be allowed to go full term and was told that would depend on my 35 weeks growth scan because my condition can hinder growth. Given that I'm almost 31 weeks, that sorta pushed me to start packing my hospital bag this week!

I dont often suggest googling because I think it can be scary but it might be worth doing some really preliminary reading to help you formulate some more questions you might not have thought about. Just don't tell the doctor you googled....as a health professional I hate knowing my patients use google as a resource but sometimes it's necessary. Check out the link below too. Very helpful but hopefully not too "medical" for you

https://www.hematology.org/Clinicians/Guidelines-Quality/Quick-Ref/530.aspx

If you have more questions, ask and I'll try to answer the best I can

camillaandcarson · February 2016

Not in people but my dog has this condition. The dog is almost a senior and has had it their whole life and it has never caused any problems. All other bloodwork comes out great, it is just that one thing. Random I know, I hope the testing goes well with you and it is nothing to worry about for you or your baby.

Roro214 · February 2016

I was diagnosed with idiopathic thrombocytopenic purpura (ITP) aka low platelets before we became pregnant. At my initial appointment with the hematologist I asked if it would effect us getting pregnant, staying pregnant, and carrying to term. The hematologist was very supportive and reassured us it has no effect on getting pregnant (we weren't trying so he was correct on that!) He told us once I was pregnant I would come in monthly to check by platelet count along with red/white blood cell count. My platelet count has dropped since becoming pregnant, but it helps reassure the OB when you see the hematologist so often. Like someone else said, the OBs get a little antsy. They just want to monitor proactively so they have time to react if there is an issue. I've been reassured many times about the different approaches and procedures that will take place if they do dip too low. Thankfully I have a fabulous team that doesn't get too stressed over my numbers falling slightly, which in turn helps me relax. Platelets dropping during pregnancy (especially your 3rd trimester) is pretty common. You just happen to be in the small minority of women who had a slightly lower count to begin with so the falling numbers require some extra monitoring. Try not to let it stress you out too much and ask as many questions as you need to! I look at it this way: just more fabulous health professionals keeping an eye on our little miracle. Good luck!

ayeshaohara · February 2016

Roro214 said:

I was diagnosed with idiopathic thrombocytopenic purpura (ITP) aka low platelets before we became pregnant. At my initial appointment with the hematologist I asked if it would effect us getting pregnant, staying pregnant, and carrying to term. The hematologist was very supportive and reassured us it has no effect on getting pregnant (we weren't trying so he was correct on that!) He told us once I was pregnant I would come in monthly to check by platelet count along with red/white blood cell count. My platelet count has dropped since becoming pregnant, but it helps reassure the OB when you see the hematologist so often. Like someone else said, the OBs get a little antsy. They just want to monitor proactively so they have time to react if there is an issue. I've been reassured many times about the different approaches and procedures that will take place if they do dip too low. Thankfully I have a fabulous team that doesn't get too stressed over my numbers falling slightly, which in turn helps me relax. Platelets dropping during pregnancy (especially your 3rd trimester) is pretty common. You just happen to be in the small minority of women who had a slightly lower count to begin with so the falling numbers require some extra monitoring. Try not to let it stress you out too much and ask as many questions as you need to! I look at it this way: just more fabulous health professionals keeping an eye on our little miracle. Good luck!

The phenomenon of platelets dropping during pregnancy has actually taken me from a high risk pregnancy to almost regular risk. My understanding is that it's a dilutional thing rather than production being altered. Interesting either way. And I totally agree with you, it's nice knowing we're being so closely watched. Peace of mind!!

folamij · February 2016

Hey ladies, thanks for the well wishes and info! According to my OB my counts were slightly low before pregnancy but not enough to be diagnosed but after conceiving, they just dropped off. I'm not below 100 which my Dr. reassured is good (and from my research).

To those of who whom have gone through testing: Is it just a bunch of blood draws? WebMD didn't really help me this time around with telling what specifically would be done for testing so I'm curious, and always like to know what I'm up against ahead of time.

Thank you all so much for your help!

kbrands7 · February 2016

@folamij My hematologist has me do blood draws every 6 weeks.

ayeshaohara · February 2016

@folamij I'm having the same. Blood test every 6 weeks

katiebug1981 · February 2016

After multiple blood draws my ob keeps telling me my platelets are low but stable so we are just monitoring for now but since I'm higher risk to begin with I will have labs done every 2-3weeks

folamij · February 2016

I hope your levels stay stable @katiebug1981

clw617 · April 2016

I wanted to bring this thread back up again to see if any STMs out there experienced low platelet count to the point where their anesthesiologist wouldn't do an epidural?

My counts are low, but not dangerously low (~130). And my OB said that one thing to be concerned about is that if it's <150, the anesthesiologist will not perform an epidural and I'd likely have to be under general anesthesia for my RCS. Some anesthesiologists will, some won't, it's their call.

But my OB said if that was the case in the week or two leading up to my CS, they could start me on a steroid treatment. I know steroids aren't a huge deal, they just sound scary. So I'm wondering if any moms received this round of treatment before delivery to up their platelet count. Did it work? Did you notice any strange side effects from the steroids?

beckyf2828 · April 2016

@clw617 I am being monitored for low platelets as well. Mine are at 99 and the hospital I will deliver at has a cut off of 100 for an epidural. I am planning a med free delivery but they have also discussed giving me steroids in case of needing a c section. I haven't had the shot yet so I'm not sure about side effects but I'm curious if anyone else has had them as well.

ayeshaohara · April 2016

If it's single dose of steroids side effects won't be huge. They tend to make you feel pretty good actually, euphoria is a common side effect!! You won't have to worry about the effects of chronic dosing because they won't apply. Generally short courses are well tolerated. They can keep some people awake so we always recommend they're taken early in the day. Hope that helps

folamij · April 2016

Counts were higher last week! Hoping they keep rising! Fingers crossed for everyone watching their counts!!

JennyS86 · April 2016

My plt started out this pregnancy at 190, and they have decreased to 119 as of a week ago. I meet with a hematologist monday morning. I am also a repeat c-section for a prior classical c-section delivery. I will update later!

JennyS86 · April 2016

hi Ladies, I met with a hematologist today, and he said that my decreased platelets are likely due to "gestational factors" or ITP. He said if they continue to decrease, it is likely ITP, but if they stay above 100, it might just be due to pregnancy. Anesthesia in our area want to treat low platelets before epidural/spinal if plt are below 75. He said they treat with prednisone (or similar) or IVIG (inpatient) as a second line choice.

After all that, my plt today were 142. haha
The plan is to get a CBC weekly until delivery and follow-up 3 months from now.

Low platelet count

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