Low platelet count

[bankie123]

Hi

I am 37wks pregnant and have been told I have a low platelet count. I have to see the doctor on Tuesday about this as they have went from 260+ at 28weeks-ish to 160 at 35 weeks to 98 at 37 weeks. Does anyone have any experience with this?

All advice welcome!

Thanks

My best friend had low platelets, around 70-80. She had to see a haematologist very frequently and was given steroids for three weeks at the end of pregnancy. She was induced at 39 weeks. She was told unless her count reached a certain level (110 I think?) she wouldn't be allowed an epidural/pethidine injection due to risk of puncturing and bleeding. Likewise had it been a section it would have been under GA. Fortunately the steroids worked and she was induced at 39 weeks and delivered with an epidural.

You could have ITP (idiopathic thrombosytopenia). It is not uncommin in pregnancy and there isn't usually a 'reason' for it or any other effects either apart from the ability to have epidural and any surgical procedures during birth. You should be followed up and you need a blood test in the beginning of labour to establish where you are. Some anaesthetists will put in an epidural with platelets of 90 and above, some are happy for lower count so it depends who you ask. It is possible to give platelets by infusion if you had a caesarean and lost blood, for example so it is not terrible in case of problems, but not being able to have an epidural could obviously be a real bummer if you wanted one.

Hope you're feeling a bit better. Late pregnancy must be difficult enough without the added stress of further bloods etc. From an anaesthetic point of view, you can have an epidural (for labour pain) with platelet counts down to about 80 (if the rest of your clotting is normal) and a spinal anaesthetic (for surgery should you need it) with counts down to about 50. Below that, the risks of bleeding get a bit higher than the risks of a general anaesthetic (again,should you need one) if you're otherwise ok anaesthetically.
What it would be worth doing is asking if you can see an anaesthetist during pregnancy (either in an obstetric anaesthetic clinic or the duty obstetric anaesthetist on call when you ask) - it means a plan can be made and put in your notes so the anaesthetist you have when the time comes has a plan to refer to, you've had a chance to discuss options in a clear headed (non labouring!) fashion and everything goes a little smoother. There are other pain relief options that you can be given information about too.
Either way, if and when you get admitted to labour ward, ask that the anaesthetist on call be informed that you're there and that you have an issue that needs looking at. Then you can have relevant bloods and a chat before things (hopefully don't) have to be done in a hurry. Good luck!