Is Pregnancy induced ITP can go away after delivery ?

[Nasar]

Kindly helps us to eradicate the below scenario,

My wife is suffering from ITP since last 3 month after conceiving (when she was 12 weeks pregnancy),

She delivered a baby boy 3 years ago with normal delivery without having any issues. She is completely normal for her first delivery.

Now She is conceived for the second time, after passing of 12th Week nose bleeding started. We checked with Doctors and they diagnozed and said that she is having a low platelet count of 7,000. So Platelet transfusion was given to stop bleeding risk. After two days she again facing brusing on skin and bleeding again started, we rushed to the hospital and found that her platelet dropped to 1000. Again admitted and IVIG given along with other cortisteroid, Predni and IVIGG seems not much helpful for her,After a hurdle of past 3 month, now she is having a platelet count of 15,000.

Normally her platelet hangs aroung between 10K to 60K for 2 month average after given IVIGG and steroid and sometime it jumps to nearly 80K, Doctors given EDD date on 1st week of sept. Now Doctor suggested us to go for Ceasarean section for delivery also Spleen removal at the same time. But we DONT want to go for Spleen removal as it was only detected last 3 month back even after conceiving the child, might be an ITP can go away post delivery.

your view is more imp. for us. Kindly suggest whether we go for CS with Splenectomy or we can wait sometime and perform Splenectomy.

[scaryteacher]

My ITP didn't go away after pregnancy, and I still have it 18 years on. I didn't have a caesarean, I refused, and my consultant haematologist backed me up. He had a lady with a platelet count of 2000 who had delivered normally.

As I understand it, there is little point in a splenectomy unless the doc is sure that that is where the platelets are being destroyed. and I wouldn't have thought that your wife would want both a caesar and a splenectomy at the same time.She would also have to take antibiotics long term.

Good luck whatever you decide, but don't let the docs bully you - the obstetrician's registrar tried it with me.

[Nasar]

We refused to go for CS and splenectomy, We are trying with normal delivery, Lets see

[scaryteacher]

Good luck, let us know how it goes.

[Nasar]

Hi Scary, can you pls confirm us your average platelet count for the past 18 years after delivery,

Also pls confirm the low count during pregnancy, is IVIG infusion given during pregnancy?

[Hidden]

I had my first child 3 years ago without itp. Then developed itp. Now 15 weeks pregnant with second baby. I am being treated with ivig. It can get my count up to over 80, 000 but my consultant haematologist and obstetrician agree they would rather give me less ivig as they dont feel it needs to be this high until nearer delivery. Unless I am bleeding. They are planning a natural delivery unless there are other complications. They havent suggested speenectomy. But ivig seems to be working for me at the moment even though it didnt before pregnancy. The baby will need to be tested after birth in case it gets my anti bodies initially and then gets a low count. Good luck.

[Nasar in reply to Hidden]

hi efd. My wife also shares the same story like yours, initially IVIG last nearly a month and when she steps to end of second trimester, ivig not helps much, it only last a week or so and then again dropped severely to 1K range. Due to severity, we have now opted to go for Ceasarean on next month end, her actual edd is 1st week of sept. Take care of your health as your health is more important for your baby, and update us..

[Hidden in reply to Nasar]

Kept me updated with what happens to your wife. Are you in the uk? Have you seen an itp specialist.

[Nasar]

No, iam from India, and my wife underging treatment from one of prominent hospital in Mumbai.

[Nasar in reply to Nasar]

My wife delivered a baby boy on 35th week of pregnanacy with Ceasarean section with 3K platelet count, 6 packets of platelets given during CS, post the count shows 10K and then goes up to 52K without steroids within a week, then suddenly dropped to 6K, again lower dose steroids started, now the platelet near on 100K.

Baby diagnosed 54K platelet count when born, then goes upto 76K with in week time, Now both are fine and discharged on 12th day. But both on observation, lets see ITP will remain or go away.

[nitindhureja in reply to Nasar]

Hi Nasar, It long time that you have posted but how is your wife doing now, Is she out of it after delivery or still seeing a low count?

[khair in reply to nitindhureja]

Hi. Count hangs between 30 to 60 k. No medicine. Currently she is fine

[arjunmech]

Hi,

My wife had done Splenectomy in 2011 and was normal after that. She delivered about a month ago and the count is around 4000. IVIG was given during her 1st month of pregnancy and was not much helpful. She was on steroids for the past 10 Months and we tapered it thinking the count would increase after delivery.The count went down to 3000 and the doctor gave dexamethason to stop the bleeding. Options such as eltrombopag and Anti-D were given but we were against it due to the long term side affects. Currently after multiple opinions she has started dapsone. Hope it works out. Would appreciate if any advice

[Nasar]

Is anyone face severe body pain with ITP, especially joints and frozen for many hours.

[nitindhureja in reply to Nasar]

My wife has ITP & she has muscle pain in the legs. Also minor joint pain in the figures & elbow.