May
19
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8 Serious Risks Of Thrombocytopenia During Pregnancy

Risks Of Thrombocytopenia During Pregnancy

During pregnancy, every test that you carry out can end up giving you goose bumps. Anything that shows discrepancy from the normal range can make your heart beat really fast. Especially, if there is anything to do with blood, it is quite likely that you may hit the panic button without realizing the actual problem.

It is normal for you to react like that, but not every discrepancy is a reason to hit the ceiling.

One such problem is low platelet count, though not very common, is a temporary condition. There can be several reasons for low platelets in your blood, and usually there is no risk.

Understanding why it happens, the treatments and other facts can help ease your worry.

What Are Blood Platelets?

Platelets are cells in the body that facilitate blood clotting when the body has to. The liquid part of the blood is called plasma and it is the ratio between the two that determines the platelet count.

  • A count of 150 to 400 million platelets per milliliter of blood is considered normal. 95% o
    f people have a normal platelet count.
  • While most women have a normal platelet count while expecting, about 8% of women may suffer from low platelet count during their pregnancy period.
  • The platelet count comes back to normal on its own within two to three months after birth.
  • A low platelet count between 100 to 150 million should not be a big cause of worry.

If the count drops below the normal, then you may be experiencing what medically is known as Gestational thrombocytopenia.

What Is Gestational Thrombocytopenia?

Gestational thrombocytopenia usually develops in the third trimester and is not known to have any harmful effects on your baby. In fact, once you deliver, your platelets will get back to their normal count.

  • Although experts do not have the exact reason, but low platelet count is said to be a side effect of pregnancy.
  • If you have found out in your reports that your blood platelet count is low, you will need to make a report of this and inform your gynecologist.

Causes Of Thrombocytopenia In Pregnancy:

During pregnancy, a platelet count can go down because of the following reasons:

  • Natural destruction of platelets occurs when they are not in use, and fresh cells are produced. This process is faster when you are pregnant.
  • Also, the production of blood is higher to meet the rise in demand for the fetus. So, the ratio of platelets to plasma can be lesser than normal.
  • Sometimes, blood thinning medicines may be prescribed during your pregnancy to avoid other complications and maintain proper flow of blood to the fetus. This also causes the platelet count to go down.
  • Preeclampsia, a condition that can happen towards the second half of pregnancy, also causes low platelet count.

Some other causes of gestational thrombocytopenia include:

  • Anti-Phospholipid Antibody Syndrome (APLA).
  • Thrombotic Thrombocytopenic Purpura (TTP).
  • HELLP (Hemolysis, elevated liver enzymes and low platelet count) syndrome.

Risks And Implications:

Thrombocytopenia can be mild or severe. Depending on the exact ratio between platelets and plasma, the level of risk is determined.

  1. It is fine if the count is anywhere above 100 million platelets per millilitre (ppm). A level between 50 and 100 million ppm is referred to as mild thrombocytopenia.
  2. Problems may arise if the count drops below 50 million ppm. This generally happens if there are other health complications or a history of thrombocytopenia.
  3. There could be a risk of excessive and abnormal bleeding either during, after birth or during cesarean section.
  4. Preterm delivery is common for women with gestational thrombocytopenia.
  5. There is, however, no risk of the condition getting transferred to your baby and she will be healthy. Cases of neonatal thrombocytopenia or hemorrhage are very rare.
  6. In extreme cases, the mother may need a platelet infusion to ensure that there is less bleeding and platelet level is fine.
  7. Abruption of the placenta and placenta previa, a condition in which your placenta is too close to your cervix, can also happen because of thrombocytopenia.
  8. Administration of epidural can be risky and doctors doing so are cautious not to cause any bleeding.

Signs And Symptoms:

Low platelet count can actually be difficult to tell by just seeing symptoms; and most often, they do not even cause any symptoms. However, in severe cases a low platelet count can result in excessive bleeding which may require urgent medical attention.

Some common symptoms that you may face as a result of low platelet count are:

  • Bleeding from nose or gums.
  • Heavy menstrual bleeding (you should inform you gynecologist at the time you first detect your pregnancy).
  • Prolonged bleeding from wounds.
  • Blood in urine or stools.
  • In severe cases, low platelet count may result in internal bleeding that can be seen in the form of blood with urine or stools or bleeding from your rectum.

Any bleeding that doesn’t stop is a medical emergency, especially when you are pregnant. Hence this would undoubtedly require urgent medical attention.

Diagnosis:

Your doctor may advise physical examination to ascertain the same.

  • Your body will be checked for any unusual bleeding or rashes that often occur in cases of low blood platelet count.
  • The most obvious next step that your doctor will advice is a complete blood count (CBC) test. This will give a definitive answer to whether your platelets are below the normal count or not.

Treatment:

If the doctor is certain that your low platelet count is nothing but gestational thrombocytopenia, in most cases you may not be given any treatment. But routine checkups will be done to keep a tab on how low the platelets are going.

  • In severe cases, continued screening and tests are required and platelet infusion may be done. Medication may be given if necessary, starting about 15 to 20 days before the delivery to control thrombocytopenia.
  • If the platelets drop is a beyond a certain limit, drugs that are safe to be consumed during pregnancy may be administered by the doctor.
  • Conducting timely tests and getting to know of your condition early is important. It will ensure that you and your obstetrician are prepared at the time of delivery.

Though, it may seem scary, you can be rest assured that low platelet count will get okay on its own post delivery. You need not fear as it will not affect your baby in any way.

If you have any tips regarding the same, please share them with other expecting mommies in the section below:

Refernce : 1 , 2 , 3

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