Low platelets and induction

[pestleandmortar]

I'm 38+1 today with my second and have a low platelet count. It was 153 at booking and has slowly dropped to 110 (as of two Fridays ago). Last Wednesday my consultant said we should do a membrane sweep this coming Wednesday, and book me in for an induction at 40 weeks - because it'll be safer for me the sooner the baby comes.

I've been speaking to lots of people with varying experiences, as well as a haematologist, an anaesthetist and my midwife. The anaesthetist was the most reassuring - she said she'd give an epidural/spinal block with e platelet count as low as 80, and worse case scenario, I'd have a c-section under general anaesthetic.

..which leads me to wonder, is it really worth the excruciating pain of an induction (and I don't know from personal experience, but I've never heard of a straightforward induction), where one intervention will lead to another, just to be sent in for a c-section? OR shall I decline/delay the induction and wait for my baby to come naturally?

I'm thinking if I monitor my platelet count week by week, I can decide at a later date if an induction may be necessary. I could go for the membrane sweep on Weds, but I've also heard that it's usually not very successful at 38 weeks.

I don't want to obviously put myself in danger. Can anyone else who has/had a low platelet count tell me what they were advised and what actually happened? Should I go for the induction?

This is so stressful. I had no issues with my first pregnancy!

My platelet count got down to 100 with DD. They monitored it every week but I was allowed to go to term and then overdue. They wouldn't let me have a home birth though. DD was born after 2 stretch and sweeps at 41+3. I had no problems with bleeding and had to have a spinal for the tear repair which was also fine. I think I just naturally have a low count, I have always bruised like a peach! This time (I'm currently 29 weeks) my Midwife has said that even if I have a low count again which is quite likely, I should be able to have a home birth and she will argue my corner. I hope it goes well for you. Good luck!

I had a low platelet count picked up towards the end of my pregnancy. I think it is naturally low anyway. I was induced at term+13.

My induction was slow and painful. I had to stay in the bed as had drip attached, therefore couldn't move around to help things along. They refused to give me an epidural because my count got ridiculously low (sorry can't remember numbers but way below 100). So I ended up having diamorphine which I really didn't want and it was ineffective anyway. Eventually they re-tested me and decided count was high enough to go through with epidural. (so I suspect they mucked up the initial test - apparently it's easy to do). At one point I asked for a section but they weren't keen to do the general anaesthetic. This was approx 48 hours after induction started. Thankfully I gave birth 4 hours after this although was assisted with forceps.

Obviously was a pretty awful experience and I would do practically anything to avoid another induction. However doctor was adamant that a CS under GA was a lot more risky which I understand and probably that is to be avoided wherever possible.

Had no problems in terms of bleeding afterwards and if they had agreed to epidural initially I think it wouldn't have been so bad.

Sorry that sounded really cold and clinical - was just trying to remember everything. Did they tell you why it's better to have the baby sooner?

Thanks for your replies.

She thinks if I delay, my platelets will only drop even lower, so she wants the baby out sooner rather than later.

I'm going to get my bloods done tomorrow and I'm hoping they wouldn't have dropped too low in the past week.

Really don't want an induction though, everyone who has had one had a horror story to tell.

There was a thread on here somewhere recently where lots of people said they had been induced and it was fine. I think my baby clearly didn't want to come out so I was unlucky in terms of length. If you think your level will be high enough for the epidural then hopefully it wouldn't be too bad. Good luck, hope it hasn't dropped too much.

That wasn't meant to be a confused face, rubbish MN app!

Thanks I'll look for the thread. I just don't like the idea of intervention when it's not absolutely necessary, and I'm scared it's just going to spiral out of control.

Bump... anyone else with low platelets?

I have low platelets permanently. Around the 100 mark, whether pg or not.

First baby - induced. Not a great experience, still suffering from birth injuries now (3rd degree tear from forceps, bowel incontinence)

Second baby - opted for c section. Spinal didn't work, cue emergency general, horrific experience. Very long recovery. Really really wish I'd opted for natural birth, even with an induction.

Sorry, I'm not really helping am I! Personally, I think I would opt for induction. Having now had a c section, I really would not ever opt to have another one. Very very painful. Long recovery. Stopped me bonding with my baby. really not a pleasant experience.

Despite the injuries, I would be induced if I get pg again.

What made the c-section so horrific?

I want a natural birth, the bit I'm debating is the induction part.

I had low platelets (the same as yours actually) and a low clotting factor, and gave birth with no issues and no induction on sunday! I had a sweep at 39 + 5 and my DS was born at 40 + 2. The obstetrician I saw set up a plan for two sweeps each a week apart and then an induction at 40 + 10. The midwives did weekly blood tests to check the level - if they were to go below 100, the obstetrician wanted to induce me, but they never went that low. I did have a managed after birth period with both the injection and a drip to make sure I didn't have a PPH but that was much preferable to an induction - although I would have been happy with that if it was really necessary.

Hope that helps in some way and good luck!

Thanks for the reassurance workingmum, and congrats on your newborn!

Had a blood test yesterday and called up for the results today - it's gone up from 110 to 116, hurrah!

I'm still debating the sweep tomorrow. I may go for it as it's not like there has to be another intervention like with an induction. Although I do have a sofa arriving on Thursday....