Low Blood platelets in pregnancy

[xjbjx]

Just wondering if anyone had any experience of low blood platelets in pregnancy and what complications that could mean?

Oops! Sending before I'm finished! Basically I'm pregnant with my second child, in my first pregnancy my platelets dropped quite considerably in late second trimester and third trimester. They were 105,000 at delivery which was deemed just on the cusp of being ok.

I'm having an elective csection this time around, my platelets were at 148,000 at 9 weeks so I'm being monitored as they expect them to drop - if they drop below 100,000 then I'll be referred to a clinic but I was told if they drop between 100,000 then that's when a spinal block etc can't be offered..... anyone have any experience of what this could mean for a csection?

Hi, I had this and actually discovered I have ITP as a result.
What is your blood count? How many weeks are you & is it your first baby? I will share my experience and it’s relevance to yours

Who has given you this figure for the spinal block? It’s the anaesthetist who will decide what figure they will attempt a spinal block. My bloods were always below 90, the anaesthetist would have attempted one spinal block if they were above 80, anything lower and it would be a general anaesthetic.

Is there a plan in place re monitoring your bloods? My trust were useless and I basically had to insist on blood counts every 2 weeks after 20 weeks to monitor

@changingusernamecosofthis ah good to hear you have experience of this too. So my last bloods were done at 9 or 10 weeks and my count was 148 (which is obviously not that low but low for first trimester). This is my second baby and I had the same last time, luckily they stayed about 100 for birth (105) but I don't see my midwife now until 28 weeks and the consultant at 32 weeks so it's just a long time to go without any sort of monitoring or information which is what has me thinking about all of this. I'm 16 weeks now, assuming they'll do bloods at my 20 week scan too.

Can I ask what ITP is please?

Hi op ITP is immune thrombocytopenia pupurea if I remember correctly.
I suffered from thrombocytopenia (low platelets) in all three pregnancies. My platelets at one stage were as low as 70 so yours at 147 although on the low side is still ok.
I had to see a hematologist monthly, I did a bone marrow biopsy to rule out any illness and they didn't find anything wrong. This only happens when I'm pregnant and after birth my platelets gradually went back up by day 5.
I didn't have any major changes apart from being told to watch out for bruising, I had a freak accident with a knife at home and bled a good bit but nothing major.
For my first with platelets under 90 I couldn't have an epidural so had a spinal block. Platelets sort of got better second and third pregnancies, over 70 bit less than 130 which is an improvement. I was monitored a lot and you will be too if they deem it necessary. I took Galfer tablets as my haemoglobin (red blood cells) was low. Best of luck.

ITP (Immune thrombocytopenic purpura) is a blood clotting disorder characterised by low platelets. I reviewed my medical history and have actually had low platelets my entire life but I’m asymptomatic, people with ITP can have issues with clotting or bruising (I’m no medical expert so I’m sure there is a lot more to it!)

That seems a long time to wait to see your midwife, it has changed since I had my second baby! To be fair, the only platelet number that counts is the one prior to your section so frequent testing may be unnecessary.

I would advise that you arrange to have your bloods taken a week before your midwife appointment so the results are there, and you ask for a referral to the anaesthetist at that point. Also arrange to have your bloods taken before your consultant appointment. I proposed this with my midwife who agreed I could arrange for bloods to be taken at the GP practice, it made so much sense as the information was available at the time of my appointments & prevented delays.

But the anaesthetist referral is essential. They will decide what figure they will attempt a spinal block, not your consultant.

Most of all, try not to worry. Your figures aren’t that low at all and I’m sure your delivery will work out. I was very upset at the prospect of a section under GA, I delivered naturally without any intervention so was lucky I was able to do this. Most interventions like forceps etc are not available if you have a low blood count.

@xjbjx just to clarify the numbers I mentioned are in thousands so 70=70,000.
With my third pregnancy I didn't have much monitoring at the start partly because I moved so different hospital to previous two. I did send in my notes and despite constant phone calls to say I don't feel well, I finally got to see a hematologist at 30 weeks(probably due to Covid and all). I would push to see one as when I finally saw her and she listened to how I was breathing I was admitted as they were worried about the possibility of a blood clot. Turned out fine but if I had been seen sooner it would have saved being admitted and have a scan of my heart lungs and brain.

This is all really great (and reassuring) advice - thank you very much! Having bloods done a week before appointments is a good idea, I'll definitely get this arranged!

As you say, my count at the moment isn't that low I'm just hoping it stays about 100 like my last pregnancy!

Thanks for all the advise :)