TOPIC:

Hi,
I am wondering if anyone had a similar experience to me and might be able to shed some light on what a future pregnancy may bring. I had never had low platelets until my second pregnancy (first pregnancy was fine). From the time of diagnosis which was about 20 weeks, my platelets stayed mostly around 50-80. The lowest was 18 (perhaps related to having had the flu???). It took 6 consequative days of IVIG to get the platelts above 50 at the time of full term delivery (booked c-sect for reasons other than ITP). I only had IVIG (no other drugs) but I had a hell of a lot of it. My platelets returned to above 150 on the third day after delivery...I was thrilled. My child's platelets were fine. I have not had any concerns since then (a few years ago).

My haematologist was great. He thinks this was ITP as I was diagnosed earlier and had much lower counts than gestational ITP. The fact that this resolved so quickly leaves me wondering if it really fits as ITP.

My concerns are that a much longed for 3rd pregnancy could see me stop responding to IVIG (this felt like what was happening towards the end last time), that my counts (or that of the baby) could go lower than last time, and that perhaps my counts would not bounce back like they did after delivery last time. I would be really appreciative if anyone can share anything that might make this feel less unknown.

Georgie.

Georgie:

Hello. Hopefully you will get some responses from women who have been through it. I had my children before being diagnosed with ITP, but I've seen many women come and go in my 13 years on this forum.

First, we've seen very few women here who actually had gestational ITP. Most of them had ITP before they got pregnant or had ITP that did not resolve after pregnancy. My observation with ITP in general (including during pregnancy) is that there are no concrete answers. Mainly, that you can't predict how the next pregnancy would go based on the last one. Your counts could be just fine or they could drop again. Antibodies come and go and there is no real rhyme or reason to it. Just curious - was your last child a boy?

Also, response to IVIG cannot be predicted. Some people find that response depends on the brand they use, how fast or slow the drip is...there are a few factors there. Have you tried Prednisone? That is another option. Sometimes a small dose works for people to get counts up quickly when they need them up.

It's important to know that in nearly all situations, everything turns out just fine for the patient and the baby. It may not always be easy, as you found out, but can most definitely be worth it.

Hi Sandi,
Thanks for the reply. I had a boy first time (no drama) and a girl the second time (ITP). I have a friend who has IVIG for other reasons and when comparing notes we found that my infusions were run very fast...I tolerated them with no real side effects (fatigue could hardly be attributed to the infusions given I was pregnant, stressed and looking after a toddler).
Georgie.

I have been discussing pregnancy with my hematologist and he says it is very normal for pregnancy to cause platelets to drop. Actually I know 2 people who do not have ITP and were recently pregnant whose platelets dropped. Gestational ITP however, doesn't get people to go into single digit platelets. We are talking around 70K and up.

The concern my Hem has had for me is that if I do want to get pregnant there is that possibility that I could go way lower than I am due to the pregnancy or not. It's just a bigger deal for ITP patients as they are already living with low platelets and another drop puts them further in risk. With all of that said, I will still plan to start my family soon and leave the rest to God.