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Common treatment during pregnancy

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12 years 1 week ago #24999 by Stefhnie
Common treatment during pregnancy was created by Stefhnie
Hello,

I have read from the board the common treatment alternatives during pregnancy / delivery were IVIG, and prednisone. Since we live in Turkey, IVIG is not available / not an alternative for some reason.

I am currently in my first trimester, and the 2 options available to raise my platelet counts are dexamethasone, and prednisone. The hatemo suggested dexamethasone, (a drug at least 5 times more potent than prednisone), to be taken over a period of 4 days x 40mg daily. There is risk of affecting the baby directly resulting in diabetic, hypertension and some other conditions. Despite the risk, this was preferred over prednisone - which I have always understood [from my - (origin) doctors in singapore] to be considered a relatively 'safe' drug during pregnancy. However the hatemo advised prednisone is unsafe for the baby during the first semester and is more acceptable 3rd trimester onwards.

If I choose to refuse treatment, then I was advised I maintained the risk of a miscarriage.
If I choose to go ahead with the treatment, then I hold the risk of the side effects.

My gynae, from another hospital is more liberal advising that the risk of low platelet counts lies on the mother, me and not the baby. He was willing to discuss ways of increasing the platelet counts by 3rd trimester.

I am not sure which is the right way to do.
Please share your experience and comments!!!

Steph

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  • Sandi
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  • Sandi Forum Moderator Diagnosed in 1998, currently in remission. Diagnosed with Lupus in 2006. Last Count - 344k - 6-9-18
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12 years 1 week ago #25006 by Sandi
Replied by Sandi on topic Re: Common treatment during pregnancy
Steph - what are your counts?

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12 years 1 week ago #25021 by Stefhnie
Replied by Stefhnie on topic Re: Common treatment during pregnancy
Sandi,

I showed the hatemo a blood test report I did sometime 12th may with a count of 23,000. I have hidden the latest count taken on 23rd may with a count of 5,000. In any case, truth will prevail as I have been asked to repeat my blood test yesterday.

I dont know what is the right thing to do.

What are your thoughts?

Steph

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12 years 1 week ago #25029 by Ann
Replied by Ann on topic Re: Common treatment during pregnancy
The usual treatment during pregnancy is low dose prednisolone. So I'd question the high dose dexamethasone.

Guidelines are here.. the pregnancy bit is away down the page a bit.

bloodjournal.hematologylibrary.org/content/115/2/168.full

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12 years 1 week ago #25058 by Stefhnie
Replied by Stefhnie on topic Re: Common treatment during pregnancy
Sandi - The hatemo rang last Friday informing my latest count at 5,000. He has asked for a repeat test on Monday (today) and suggest for immediate medication. I did not turn up at the office.

Ann - Thanks for the article.It is very useful. In the worst case scenario, I may consider low dose of prednisone to reach a stable count and then wait and see. Are you in remission - what is your present mode of treatment - how did you manage your pregnancy, if any?

Rgds
Steph

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  • Sandi
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  • Sandi Forum Moderator Diagnosed in 1998, currently in remission. Diagnosed with Lupus in 2006. Last Count - 344k - 6-9-18
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12 years 1 week ago #25082 by Sandi
Replied by Sandi on topic Re: Common treatment during pregnancy
You probably want to do something, Steph. I hope you have a Hemo and GYN that you trust. Let us know how it goes.

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