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Thrombocytopenia In Pregnancy
Get the facts on Thrombocytopenia In Pregnancy treatment, diagnosis, staging, causes, types, symptoms. Information and current news about clinical trials and trial-related data, Thrombocytopenia In Pregnancy prevention, screening, research, statistics and other Thrombocytopenia In Pregnancy related topics. We answer all your qestions about Thrombocytopenia In Pregnancy.
Question: Low blood platelet counts "thrombocytopenia" in pregnancy? I'm currently 13 wks pregnant. My doctor told me that my platelet counts have been falling since week 6, when they were already low. (116, now 78). I guess normal is >150, and severe thrombocytopenia is <50.
I've been referred to a hematologist for further guidance, and my appointment is in two weeks. While I'm waiting, I was wondering: has anyone else ever had this, and what happened with them and their baby?
Answer: I found this for you...:
The diagnosis and management of thrombocytopenia during pregancy presents difficult diagnostic and management
problems. The diagnostic distinction among the potential etiologies for thrombocytopenia is often impossible, yet the
diagnosis has major importance for management. Furthermore, management involves not only the care of the mother, but
the anticipation of risk for thrombocytopenia in the infant. The following are the major etiologies for thrombocytopenia
during pregnancy:
Gestational Thrombocytopenia. In many women, mild thrombocytopenia occurs toward the end of pregnancy, and the
platelet count returns to normal within days after delivery. The etiology for this phenomenon is unknown. This is the most
common cause of thrombocytopenia during pregnancy, occurring in approximately 5% of women at term. Gestational
thrombocytopenia is characterized by: (1) asymptomatic, mild thrombocytopenia, (2) with no past history of
thrombocytopenia (except possibly during previous pregnancy, (3) that occurs during late gestation, (4) that is not
associated with fetal thrombocytopenia, and (5) that resolves spontaneously after delivery. Platelet counts are typically
over 70,000, with about two-thirds being between 130,000 and 150,000 (just below the lower limit of normal). Idiopathic
thrombocytopenic purpura (ITP), cannot be distinguished from gestational thrombocytopenia with certainty because the
diagnosis of both conditions is based upon the observation of thrombocytopenia with no other apparent cause. Although
ITP may compose a higher percentage of cases when the platelet count is less than 70,000, or when thrombocytopenia is
discovered earlier in pregnancy, gestational thrombocytopenia may still be the appropriate diagnosis if the
thrombocytopenia resolves spontaneously after delivery. However, severe, refractory thrombocytopenia, presumably due
to ITP, may also remit after delivery.
The differential diagnosis between ITP and gestational thrombocytopenia is generally of little clinical importance with
regard to the mother, because cases in which the diagnosis is unclear involve mild thrombocytopenia that does not threaten
maternal health. The differential diagnosis is clinically important with regard to the fetus, because ITP with even mild
thrombocytopenia may cause thrombocytopenia in the fetus, whereas gestational thrombocytopenia does not. Current
tests for identifying anti-platelet antibodies do not help in the differential diagnosis.
Idiopathic Thrombocytopenic Purpura (ITP). As described above, thrombocytopenia first discovered during
pregnancy may be either ITP or gestational thrombocytopenia. The most important diagnostic step is to search the
patient's record for evidence of thrombocytopenia when she was not pregnant. If no prior platelet counts are available,
then the distinction rests upon the severity of thrombocytopenia and the time of its occurrence during pregnancy. More
severe thrombocytopenia occurring earlier during pregnancy is more likely to be ITP. Management of the mother with ITP
during pregnancy is essentially the same as in a non-pregnant patient, only the management is more conservative.
Splenectomy hopefully is deferred until after delivery, and cytotoxic agents are avoided.
The major focus of concern is on the risk for neonatal thrombocytopenia. In contrast to fetal alloimmune
thrombocytopenia, which may be severe and cause intrauterine fetal hemorrhage, intrauterine fetal hemorrhage has not
been reported in ITP. The main concern is for trauma at birth and its risk of provoking cerebral hemorrhage in the
newborn infant. This serious complication is rare. Among infants born to women with ITP, 10% have platelet counts less
than 50,000. Only 4% have counts less than 20,000 and are therefore at risk for hemorrhage at birth. Although it seems
reasonable that cesarean section delivery is safer for the infant than vaginal delivery, there are no data to support this
hypothesis. Current obstetrical recommendations are to proceed with routine vaginal delivery, reserving cesarean section
for obstetrical indications. It is important to recognize that intracerebral hemorrhage may occur following birth, as the
platelet count may fall further during the first week.
Preeclamsia. About 5 to 10% of all pregnant women have preeclampsia, defined as hypertension and proteinuria
beginning during the second half of gestation. From a hematologic standpoint, preeclampsia is the second most common
cause of thrombocytopenia during pregnancy, since about 15% of patients with preeclampsia develop thrombocytopenia.
It is managed by obstetrical care, with delivery resulting in predictable resolution. The difficulty is to distinguish
preeclampsia from thrombotic thrombocytopenic purpura / hemolytic-uremic syndrome (TTP-HUS).
Thr
Question: Thrombocytopenia (ITP) and pregnancy? I had thrombocytopenia (ITP) and have been in remission since 1997 after splenectomy (removal of the spleen). I would like to know if anyone has information on how pregnancy might affect my remission. Could my platelets drop again? Might my baby develop ITP before birth? Are there any new treatments available for people without spleen? I hope that someone might help me with this because doctors can tell you probabilites but I'd like to know from someone who has been there first hand. Thanks.
Answer: well you should always be vigilant with your history of ITP...but if it hasn't been a problem since '97 then it shouldn't . However, being pregnant can affect your platelets...so with your doctors help you can keep track of your count. Treat as necessary...Your baby should be fine.... hope it goes well
Question: Thrombocytopenia? I don't know if anyone knows what that is, but I figured I would ask anyways. Anyone know, heard or experienced it..Something like neoatal alloimmune thrombocytopenia...something like that... My previous pregnancy has very similiar if not exact symptoms of it and so I am going to get checked for it.
Answer: Neonatal Alloimmune Thrombocytopenia
Neonatal alloimmune thrombocytopenia is the platelet equivalent of hemolytic (Rh) disease of the newborn, developing as a result of maternal alloimmunization to fetal platelet antigens. It affects one in 1,000-2,000 live births and can be a serious and potentially life-threatening condition (12, 13). Unlike Rh disease, neonatal alloimmune thrombocytopenia can occur during a first pregnancy. Almost half of the clinically evident cases of neonatal alloimmune thrombocytopenia are discovered in the first live-born infant (14).
In typical cases of unanticipated neonatal alloimmune thrombocytopenia, the mother is healthy and has a normal platelet count, and her pregnancy, labor, and delivery are indistinguishable from those of other low-risk obstetric patients. The neonates, however, are either born with evidence of profound thrombocytopenia or develop symptomatic thrombocytopenia within hours after birth. Affected infants often manifest generalized petechiae or ecchymoses over the presenting fetal part. Hemorrhage into viscera and bleeding following circumcision or venipuncture also may ensue. The most serious complication of neonatal alloimmune thrombocytopenia is intracranial hemorrhage, which occurs in 10-20% of infants (14, 15). Fetal intracranial hemorrhage due to neonatal alloimmune thrombocytopenia can occur in utero, and 25-50% of fetal intracranial hemorrhage in untreated mothers may be detected by ultrasonography before the onset of labor (16). Ultrasonographic findings may include intracranial hemorrhage, porencephalic cysts, and obstructive hydrocephalus. These observations are in contrast to neonatal intracranial hemorrhage due to ITP, which is exceedingly rare and usually occurs during the neonatal period.
Several polymorphic, diallelic antigen systems residing on platelet membrane glycoproteins are responsible for neonatal alloimmune thrombocytopenia. Many of these antigen systems have several names because they were identified in different parts of the world concurrently. Recently, a uniform nomenclature has been adopted that describes these antigens as human platelet antigens (HPA-1 and HPA-2), with alleles designated as "a" or "b" (17). Although there are at least 10 officially recognized platelet-specific antigens at this time, more than 50% of the reported cases in Caucasians and most of the severe cases have occurred as a result of sensitization against HPA-1a, also known as PlA1 and Zwa.
Fetal thrombocytopenia due to HPA-1a sensitization tends to be severe and can occur early in gestation. In a cohort study of 107 fetuses with neonatal alloimmune thrombocytopenia (97 with HPA-1a incompatibility) studied in utero before receiving any therapy, 50% had initial platelet counts of less than 20,000/mL (13). This percentage included 21 of 46 fetuses tested before 24 weeks of gestation. Furthermore, this series documented that the fetal platelet count decreases at a rate of more than 15,000/mL per week in the absence of therapy.
The recurrence risk of neonatal alloimmune thrombocytopenia is extremely high and approaches 100% in cases involving HPA-1a if the subsequent sibling carries the pertinent antigen (13). Thus, the recurrence risk is related to the zygosity of the father. As with red cell alloimmunization, the disease tends to be equally severe or progressively worse in subsequent pregnancies.
Question: Intracranial Thrombocytopenia? Afternoon all,
Firstly as i type this i am 100% serious, and i swear am not looking for sympathy, just maybe some one to talk to who has the same condition or if you know some one who has gone through this.
In 2001 i was pregnant with my first child, me and then hubby (now ex) obviously were very happy, then at 8 months into the pregnancy we found out our baby had Intracranial Thrombocytopenia, this is basically where the antibodies in my body attack the placenta and kill the baby's platelets, the baby's platelets can not clot and the baby has a massive bleed on the brain and in the head. This is such a rare condition that my consultant had never seen it before in his 30 years of medicine...
Any way the only reason we found out about this was that the midwife came out to my home as i had really bad back and couldn't walk she said "oh your baby is small for 8 months, i'm sending you for a scan" after a scan and an internal i was taken to the foetal medicine unit in the next city over (Newcastle RVI) (UK) and that is when they found out. By this time i was 8 1/2 months gone and my only option was a termination as the baby would never have survived birth there was less than 1/4 of his brain left alive due to the massive trauma of the internal bleeding.
We had a funeral for him and we had to register him as still born. Me and hubby eventually split up, we are still friends but the stress was too much for us.
I am with my new partner now and we are trying for a baby next year after we are married, and this WILL happen again ! so from 18 weeks i will have to have treatment one a week for 4 months, if this doesn't work i will need steroids and the baby will need platelet transfusions whilst in the womb up until 32 weeks then i will have the baby (if it survives the transfusions - there is a 3% of miscarriage) by caesarean. This is going to be a massively stressful time for me and my other half but i hope i have learned to be more open with my feelings. There is only at 25% of me having a healthy baby, i know 25% is better than nothing, but the selfish part of me wishes it were 100%...
It would be so great if i knew some one else with the same condition maybe that has been successful and had a baby, just some one i can talk to. Like i say it's such a rare condition my doctor can't even put me in touch with some one, so there is no chance of a support group !
This is not hereditary either, my sister got tested and obviously my mum had us 2 so they don't even know why it's happening to me.
I know this is long, but thanks for your time in reading. x
Answer: Firstly, I want to wish you all the best of luck. It sounds like it could be a mighty streeful time. I'm not 100% sure if this is suitable, but there is an online yahoo support group for something which sounds similar - http://health.groups.yahoo.com/group/NAI… - maybe check it out and hopefully someone out there might have had similar experiences. Best of luck xxx
Question: Has anyone else ever heard of or had this disease?? Its called Thrombocytopenia. I have the pregnancy induced kind. Has any one ever had this, Just wandering if it gets worse or better with your next pregnancies?
Answer: Search it on google ull get all info
Wadup007
Question: What should i do!? My husband and i have two boys 4 and 19months, we really want a girl, we started to try last month, some of you might of seen my obssesive questions, any ways. When my family found out we were thinking of having another baby, they went balistic on me. I am a full time college student and have had some problems in my last pregnancies. It was controlled alot better though in my last pregnancy. I have pregnancy induced thrombocytopenia, which is where my platlets drop and no one really knows why. The Dr. says its ok, and I realy would like to have another one, i don't want there to be too much space between the ages of m children. I will never hear the end of it if i do have a baby though. I know its my choice but, do ya'll think i'm being stupid (this is what i was called) by having another one right now? I am busy but, i know my husband and i can work it out. Please give me support. (if i can't get it from my own family, i'll get it from my ttc family--LOL!)
I am going to be a RN, i have 2 years to go, my 4 year old starts pre-school in august, and we are financially stable. My family thinks i'll drop out of school or something bad hapen to my health.
Answer: because your doctor knows what happens when you get pregnat, he will already anticipate this issue and be able to deal with it mmediatly. You are not stupid to want to give your husband the greatest gift you ever could, children!! My ant has 3 children, watchews babies part time and still graduayted and can do a nursing job. Sounds like your husband is supportive and that you have a very stable life so i would go for it and enjoy the blessing of another little! they are such a joy and I bet the family wouldn't mind be an uncle, auntie, etc.. again. Your doctor will be fully prepared to control the situation!
Question: should i have another baby , i have had probs. in the past? OK, so i have 2 boys ones 3 and the other is 18 months. i have what is called pregnancy induced thrombocytopenia. With my first i had alot of probs during delievery, i had no pain meds and did it all natural, i almost bleed to death, they thought about doing a hysterectomy. With my second they knew what was going on and put me on steroids to raise my platlet count, i had a c-section and everything went fine, but even witht the steroids my platlets dropped to 50,000 (normal is tween 150 and 400,000) my hubby wants to try for a girl, and so do i, but i'm scared of what might happen, so the question: should i try for a girl?
after the first one they told me it wouldn't happen again, then with my second one i saw a specialist and he said as long as my platlets stayed at or above 50,000 it would be ok. thing i'm scared bout though is what if they drop below that.
Answer: Is it really worth trying again if It could kill you? Would that be fair to your hubby left to raise the boys and possibly the baby that was born when you died? The boys could think you died because they weren't enough to make you happy and the little baby could grow up hating themself for killing mommy. I see these sorts of things quite a bit with some of the kids I counsel.
If you and hubby really want a girl consider adoption there are many unwanted girls in orphanages in China just waiting for loving parents.
Question: Has any one had this disease?? Its called Thrombocytopenia. I have the pregnancy induced kind. Has any one ever had this, Just wandering if it gets worse or better with your next pregnancies?
My Dr. doesn't know why it only comes in my 3rd trimester.
Answer: http://www.emedicine.com/med/TOPIC3480.H…
Sorry i have not had this disease... But thank you for posting your question i had never heard of it before but i looked it up on the net and wow...
I hope the site i got for you was ok it has so many details on it!!
I wish you all the good luck i can give
Big Hugs
Question: Has anyone had this disease?? Its called Thrombocytopenia. I have the pregnancy induced kind. Has any one ever had this, Just wandering if it gets worse or better with your next pregnancies?
Answer: Gestational Thrombocyopenia (GT= pregnancy induced) has several names. It is also known as essential, benign, or incidental thrombocytopenia.
It occurs in about 8% of all pregnancies. Gestational Thrombocytopenia accounts for more than 70% of cases of thrombocytopenia in pregnancy.
The cause is unknown but, it is thought to occur because of an increased consumption ( the body uses more platelets during pregnancy)
1) Usually, GT is noticed on a blood test called a CBC ( complete blood count) and is found, usually, after late second trimester.
2) GT may occur in future pregnancies, although the recurrence rate ( how often is occurs) is unknown.
3) Platelet counts return to normal within 2-12 weeks following delivery
The risk of the baby ( fetus or newborn) having this, is extremely low.
I hope that this is helpful and, if you have any concerns or questions, speak to the Nurse at the Doc's office. She will be able to answer any additional questions that you may have.
Question: Thrombocytopenia (ITP) and pregnancy? Hi, I would just like to know of any women who have ITP and are or were pregnant. Were there any complications? What medicines are new on the market? I have been in remission for almost 10 years post-splenectomy. What, if any, are the risks of relapse if I get pregnant and how might it affect my baby?
Answer: Idiopathic thrombocytopenia purpura is the result of hyperspenism and removing the spleen cures it. I see no reason to fear a relapse during pregnancy or any problem with the baby. MD
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