Low platelets= hospital birth?(13 Posts)
I'm due anyday and booked at home. Feel prepared, have my pool, done hypnobirthing/ visualisation, etc. Now my MW has said my platelets are low and she's trying to get 2nd opinion on whether I am 'allowed' my homebirth, but there's no plan to treat it. However if its not low enough to treat then why should it affect my birth choice?
Any info is gratefully appreciated if anyone knows, such as how to boost them, actual statistical risks, etc.
I had this. MW booked me to see the consultant & discuss. I think the issue is bleeding out after, so I agreed to have the managed 3rd stage & platelet count done at 39wks. DS was born at home at 38+6
Oh thats reassuring. Did it cause excess bleeding? I've said I'm happy to compromise and have managed 3rd stage, but feel little reluctant to go into hosp when that's the only difference.
Try and get your bloods done before labour and hopefully your platelets are up to a normal level.
If your home birth doesn't work out and you end up at hospital they won't give you an epidural if your platelets are low - that would mean a c section would be under general anaesthetic.
I had far less bleeding this time than with my first, so I'm not sure what impact the low platelets had, if any. I suspect I always have a slightly lower count naturally & I may have had a low count with my first, but it wasn't picked up as I don't remember having the last set of bloods done...
The low platelet count was written v clearly in my notes and I flagged it up to the MW that came here, but otherwise I don't think they were low enough to cause any major concern.
I can't remember what sites I read, but did Google it. Also, since the conzul
Sorry, fat fingers...
Since the consultant wanted the bloods at 39wks when I was 37wks or thereabouts, I got her to agree to support the hb in the meantime. Hence the fortuitous timing of DS's arrival
A mild lowering of the platelet count is normal in pregnancy - it depends how low is low. most places would get a bit jumpy at less than 100 and less than 70 may mean no access to spinal if an emergency CS is needed. VB 'safe' at lower levels than this, but I can see why they would be hesitant about delivery outside of the hospital as there is a real risk of significant bleeding.
I would request an alternative method of plt counting eg immunoplatelet count as likely the platelets are too big to be counted properly by the conventional blood count method (common in pregnancy) - if the count is much higher (usually is) then everyone can relax.
How low are they? Mine are 117, down from 151 at booking (which is the very lowest end of normal).
My consultant said that they won't affect anything unless they drop below 50, in which case they won't allow an epidural. He said it's unlikely to cause a PPH as that is more iron levels and the action of the uterus.
Mine are being retested at 34 and 38 weeks ( I'm currently 32).
My platelets drop to between 90-110 in pregnancy and have gone lower to 60-70 at times. Number of hematologists have told me they wouldn't start getting worried until under 50 and even then not really an issue until 20-30 ish. Also been advised that you can have low platelet count and but blood clotting ability is fine so make sure this is tested too. My ante-natal consultant also told me I wont be 'allowed' a homebirth if levels are around 100 because of policy but having done a lot of research myself and with the support of my independent midwives, I wont be ruling it out purely on this reason alone. Only thing that would be different is that we would keep am even closer eye on bleeding during natural third stage just in case.
I've ranged from 135 down to 101 currently at 38 weeks. Apparently on looking into it further, the guidelines for my unit are cut off for homebirth of 100, so I will argue the toss tbh. Worried if I retest and its dropped further then I might reduce my options though.
Thankyou so much for your help. If I get an official 'no' then I'll make a list of qs to ask.. what are exact risks, research, etc.
Has anyone had any clinical symptoms? I get nose bleeds and feel knackered easily, but have heard that sometimes there's no signs
<cough> no such thing as not 'allowed' <cough>
Might be worth asking on the Yahoo homebirth site for advice too, as well as looking at www.homebirth.org.uk
My platelets are now 107 so homebirth all booked, yay! (I'll decline anymore blood tests)
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