What is it with all these random ailments and illnesses that rear their head during pregnancy? As if we don’t have enough to deal with as it is.
During both my pregnancies I suffered with low platelets. Something I didn’t find out about till very near the end with Molly which is quite worrying. I do remember telling my midwife at my booking in appointment that my mum had haemorrhaged after giving birth to my brother. You know, just in case it was useful. Nothing else was said about the matter.
Then at 35 weeks I discovered I was very ill with Obstetric Cholestasis. You can read all about that here. Let’s just say it was a rather stressful time with daily blood tests. When doing my daily pin cushion impression they also told me I also had low platelets. With everything else going on it wasn’t really something I paid too much attention to. The OC was my main focus. Looking back the low platelets was probably almost as much of a concern.
What are low platelets?
Low platelets mean your blood is unable to clot properly. It leaves you in quite a dangerous position should anything happen to you during pregnancy. Like slicing my finger or so on! More importantly it means there is a high risk during labour of bleeding and haemorrhaging.
There are different danger levels of low platelets. The normal number of platelets is between 150 and 400 million per millilitre (ml) of blood but about 8% of pregnant women experience low platelets. They class your count as below normal if you have between 100 and 150 million per ml of blood. You will probably see your results written in your note as something like ‘Plat. 180 x 10.9/L’. This means you have a count of 180 and are therefore in the normal range. Below 100 is very dangerous. My lowest was 15! Luckily mine went back up quite quickly to around 80. Still dangerous but not quite so ridiculous.
Although I call it low platelets the correct term is gestational thrombocytopenia. It normally occurs in the final trimester and miraculously disappears once you give birth.
What does it mean
There isn’t any danger to your baby with low platelets. They also don’t really know what causes it. It seems to be one of those pregnancy symptoms that just appears. Something to do with your body speeding up the destruction of platelets during pregnancy. It can however be linked to other conditions such as rare forms of pre eclampsia or previous conditions such as Lupus. It is likely mine was linked to the OC but we can’t be sure.
It also explains why after never having nose bleeds in my life I had the most mammoth ones ever!
Care and Treatment
I was already under consultant led care with Alice due to the risk of developing OC again. Although I miraculously didn’t get that again I did get low platelets again. This was picked up quite early this time. Again I dropped to dangerously low levels. I had to see a blood specialist to discuss treatment options and also I had to have blood on standby in the delivery room in case I needed a transfusion.
The treatment may mean taking steroid tablets, or having an infusion of globulin (IVIG). Or your doctor may recommend that you have a transfusion of platelets or plasma to increase the platelet levels in your blood.
When my levels were at their lowest with both pregnancies I knew that should I need an emergency c section that it wouldn’t be an easy procedure. I would need to have a general anaesthetic to knock me out completely as the risks were too high otherwise. This wasn’t something I relished the thought of.
I also knew I probably couldn’t have an epidural. I was actually offered one when I was in labour with Molly which in the throws of labour I thought I wanted. Luckily I never got to that point. Apparently on the day of labour my levels had gone back up so it would actually have been safe to do so.
Although they were monitoring the situation with Alice I did get a bit worried near the end. My levels kept falling and I was also concerned about developing OC again. It was therefore decided that I would be induced at 37 weeks. It isn’t necessarily recommended but given my previous history we felt it may be safer all round.
A few weeks after giving birth I had to have blood tests repeated and what do you know I was back to normal! Our pregnancy bodies are both very strange and very amazing things.
Has anyone else experienced low platelets and how did it affect you?
Hi Lottie. So nice to see I’m not alone! Ive suffered with low platelets (Known as ITP) all my adult life. I’ve never really had any major problems just the odd course of steroids and other treatments over the years when I’ve needed it. My platelets tend to cruise at around 30 on a good day yet as soon as we found out i was pregnant we dropped to 8!! I reluctantly went straight on the steroids and have spent most of my pregnancy with a count of about 30 which has been fine but now D-Day is approaching, 4 weeks to go(!!!), we’ve had to increase my steroids and luckily they are heading the right way. I’ve been so well looked after by my consultant OBS and Hematologist throughout that i haven’t felt worried yet. For a C-Section of Epidural i would need a count of 75+ so that’s the aim now for the next few weeks to get them to that magic number, that may mean extra steroids or possibly a transfusion at the last minute to give me a boost. I’ve got everything crossed for a natural birth but do have the concerns of bleeding afterwards, especially when I’ve spent my whole life having to report any heavy bleeding straightaway! It’s always a hard one to manage as there is no pattern or ‘routine’ that your platelets behave in so there’s little you can do to increase them although there is some research out there to suggest that certain foods can increase them and trying to avoid stress and trauma (Easier said than done for us Preggo ladies ; ) ! ). Keeping positive and trust those Doctors, they know what they are doing! x
Gosh, 8 is low. It’s pretty scary isn’t it and hats off to you for coping with it all the time. I only had it during pregnancy and luckily it is back to normal now but I have a friend who has just found out she has low platelets constantly which she is finding tough. You will be fine during pregnancy and hopefully you won’t need that epidural or c section. I somehow managed on just gas and air so it is possible (I’m a wimp normally with a very low pain threshold!). Hopefully after birth you will be monitored really closely so sure you will be in good hands. Good luck and let us know when baby arrives xxx
Oh poor thing. She’ll be fine once she gets used to it. My platelets have been as low as 2 before and that’s only because I’d picked up a nasty virus. Try to avoid the steroids as much as she can. Most of the time it doesn’t cause any problems (Unless she wants to become a Rugby player or champion Trampolinist!?!)
It is amazing what your body can do normally, let alone when you’re pregnant I’ve found so I’m just trying to trust what is happening and let my body do what it’s meant to do. Gas and Air and Jelly babies will hopefully get me through : )) x
Oooh, I forgot the jelly babies! Wish I’d thought of that! xxx
Hi Lottie, I also had low platelets in pregnancy, although I think the lowest they got to was 90. I was told that if I did want an epidural during labour I may be able to have one, but that if have to have a blood test first to check my platelets, which would mean a delay of at least an hour in getting one, so some forward planning might be helpful.
The extra blood tests were a bit of a nuisance, and I can imagine with OC you really didn’t need another complication thrown in!
I’m a doctor myself, and I just wanted to add that I think this is brilliantly written – the right level of detail, explained perfectly and completely accurate. Thanks!
Ah, thank you for your lovely comment Hannah. That is so lovely of you to say. It’s always hard trying to remember everything! I think luckily the docs are great at managing it during pregnancy and hopefully most people can get their levels back up one way or another. I was lucky that I didn’t have to have treatment in the end as mine kept yo yoing and were normally back up when they needed to be. Blood tests became a part of everyday life for me by the end. Not so easy on the second pregnancy when I was also trying to control a wayward toddler at most appointments!!! xxx
Agreed! No scary stories or exaggerated symptoms like some articles you can come across online! Well Done Lottie x
I potentially have the opposite problem – I have a blood clotting disorder called Factor V Leiden, which causes blood to clot more easily. It was only diagnosed when my Dad had a pulmonary embolism (it’s genetic!) but it can mean a higher risk of miscarriages so I’m pretty nervous about it. I’m currently waiting on my doctors to get back to me about what I should do once I’m pregnant (a previous GP mentioned daily injections of a blood thinner but there’s no hard and fast recommendations), it’s very annoying having this postpone trying for a baby because of this but obviously it’s not sensible to go ahead without a clear plan! I’m just so impatient! Still going to take the advice above, though – whatever happens, trust the doctors!
Good luck Katie. Having had quite severe complications in both pregnancies I know that you will get through it. The doctors will come up with a solution and fingers crossed it all works out well for you xxx