ITP - counts in pregnancy

For those who went through pregnancy with ITP in remission (to start with), how your platelets behaved in the third trimester? My ones are within normal range but slowly sliding down from 300+, about 15% every 2 weeks so far. I know this is partly due to dilution because of increased plasma volume, but wondering if it's also gestational or ITP creeping slowly back.

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  • Both pregnancies were completely different. My platelets were low for my 1st pregnancy requiring intervention for almost the entire pregnancy through delivery.With my 2nd pregnancy my platelets were within the normal range (on 2.5 mg of prednisone every other day) but suddenly dropped at week 39 which led to me being induced. Platelets are now returning to normal.

  • Thank you! If I may ask, what were your platelets during delivery? Are you under any treatment now?

  • 1st time they got my platelets to about 80k before they induced me. This time i believe i was at about 96k before they induced me. Im currently on 10 mg of prednisone. I have been on prednisone for 20 years. varying doses. Is this your 1st pregnancy?

  • Yes, it is. Thank you, these are good benchmarks to understanding what to expect!

  • The reality of my situation (I don't know about yours) is that my platelets count can fluctuate so drastically and unexpectedly. I can never really predict anything. Nor would I be able to tell you what to expect. I had 2 COMPLETELY different pregnancies. The only "advice" i will give you is to NOT worry. Do your best to relax and trust in God if you are a believer and your medical Team. You should also be aware that your platelet count has to be a certain number (each doctor has a different number) in order for you to have an epidural. My doctors would not give me an epidural for my 1st pregnancy because my platelet count was not high enough. I found out at the last minute that an epidural was not an option for me. With my second pregnancy my platelet count rose much faster so i had the option of an epidural. Are they planning on inducing you or is the plan for you to carry and deliver full term?

  • Thank you! My ITP tends to go into prolonged remission (once it was 9 years! And now 3rd year) and then relapse suddenly and dramatically. The plans are either c-section or induction, this is also because of my age - they won't wait past due date. Yes, I heard epidural needs at least 80k and 100 k in some other hospitals, I would really want it if I go naturally. Fingers crossed for them to stay above 100k.

  • Fingers crossed for you.

  • Thank you!

  • My counts were below 10k when I was concieved. Then initially i was on Prednisone and countwent upto 50k at max. Then 4th month i was given IVIG which took it till 80-90k and then it was hovering in 40-50s and 20-30s in 3rd trimester. a week before due, i was given IVIG again and then induced with count of 60-80 and I had normal delivery. I was also given Platelets and not sure how much. But then a week after delivery, I suddenly had heavy bleeding which doctors say due to ITP but elder ppl say, might be due to left over clots during delivery. Then doctors removed all the clots which was kind of 2nd delivery :( . Then my baby had neonatal ITP and was kept in NICU. Then after a week it went above 100k and discharged. It was not at all a good delivery experience but I got a healthy baby for which am thankful.

    Dont worry and good luck to you.!!

  • Thank you! Must have been difficult to go through this, very happy for you that baby is fine!

  • Yup it was and that's why scared of 2nd baby though my 5yr old girl asks to go and get a baby sister from hospital everyday. :D ;)

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