TOPIC:

Hi, it seems this board it rather quiet but I'm hoping for some comfort. I had mild gestational thrombo with my last pregnancy. Low platelets at 84k discovered at labor admittance. Not a big deal, went up immediately after delivery.
Fast forward to this pregnancy, normal platelets until 28 weeks, hovered above 100k until 36, and the dropped from 100 to 42 in 11 days. New diagnosis of ITP came with the drop. I am so scared. I was started Monday on a pulse high dose of dexamethasone, 40mg/day, 4 days, and take my last dose tomorrow. Labs will be drawn on Friday, and induction is scheduled for monday. I wish I knew if I would respond. I've never felt so out of control of my own body before, and I terrified they are going to drop lower. I would love some encouragement please!

The board has been quiet the last week or so, but it's usually not. At any rate, I'm still here!

This drop sure did come at a bad time, but let me assure you that any OB/GYN or Hemo who is familiar with ITP will get you through this. There are some things that they can do prior to delivery so things will be safe. You'd need a count of around 100 in order to have an epidural. If counts are not that high, you may have to deliver without one. I've done it while induced so it is possible. Not fun, but possible. Many women have delivered safely with counts under 50. Not an ideal situation, but again, possible.

You are getting a count done on Friday, so you will see if you are responding. It's kind of cruel to stick you with Decadron right now since the withdrawal can be horrible. Also, some people totally crash a few days after stopping the drug. Then again, some people don't. If you drop, they might try IVIG before delivery which has a good response rate and it works fast. I'm sure they will do that if counts are low. Also, platelet transfusions can be helpful during labor and delivery.

Worse case scenario, they will reschedule the induction until your counts are acceptable, whatever count your doctor decides that will be. I know it's a scary time, but they'll do whatever it takes to make sure that you and the baby are safe.

Hi, I'm 34 weeks and 3 days. Recently diagnosed in March with platelet counts of 38. Was given 60mg of predisone and body responded well, platelet counts jumped to 85 and slowly got lower. Went in for routine blood count and came back with a count of 4 last week friday. Was rushed into high-risk hospital and given 3 day treatment of IVIG. platelet count went to 47, was discharged from the hospital. Went back for follow-up yesterday, and count was at 8. confused at low number bc i have no active bleeding, feeling great, have color but counts still low. given 4 day treatment of dexamethasone at 40mg will go back on monday to check counts. scared about platelet counts during delivery and if higher steroid will work. not wanting to induce labor, and hoping to let baby come when she's ready. baby is completely fine, growing perfect, strong heartbeat and very active. feeling overwhelmed and scared about such low numbers but would rather be home than stuck in a hospital. was told by hemo that we want counts in the 30s during natural delivery since idk if well be able to get to counts high enough for a epi. first time pregnant and really overwhelmed by everything. any suggestions is welcomed!

All I can tell you is to allow this to be in your doctors hands. He/she/they will get you through it. Not having symptoms is a very good thing. Sounds like they are doing everything possible to get your counts up.

I had 2 of my children with no meds and preferred it that way. No, I am not one of those barefoot fanatics that delivers at home with a midwife. Just didn't want a needle in my spine. I did the breathing, cursed at my husband for hours, and got through it.

I hope all goes well for you. Please keep us updated!

Alroth - how are you doing?

Hi all, I just wanted to update:

The pulse dose of dex worked beautifully. Count went up to 130 after 4 days and up to 186 by delivery, 7 days after first dex dose. I had a wonderful,uncomplicated delivery.

However, I won't sugar coat. Dex was horrific while on it and even worse getting off. The day after my daughters birth, I had a terrible episode/panic attack/psychosis that my hema believed was caused by the combination of birth hormones and steroid withdrawals. I ended up spending three extra days in the hospital. It has taken me awhile to get over that experience. From what I understand, it is not that common.

My daughter's platelets dropped until four days after she was born, then went up rapidly from there, and we were able to go home the next evening.

My platelets peaked three weeks after delivery at 216 and have trickled down since. Last level was 122. Hoping this was just a severe gestational case of ITP, but the steady drop doesn't leave me very optimistic. I have another count done tomorrow, so we'll see. At this point, I am far more terrified of steroid treatment than low counts.

However, despite the troubles I love that sweet baby girl, and I am so happy to have her.

Having horrible side effects when stopping Dex is pretty common. Many people have said it's awful. Your counts are doing quite well for being off of Dex for so long...most people have a pretty fast drop when stopping.

Congrats on the baby and I'm glad things went well with the delivery. If you do ever need treatment again, there are options other than steroids. Your case seems to be far from severe and having counts stay up for this long is a very good thing! Good luck to you.