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38 weeks. Platelets 80,000. Steroids or no steroid

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9 years 7 months ago #44427 by jillspeechpath
I am at my 38th week of pregnancy and my platelets have been hanging around 70-85,000 for the past 2 months. Ob/gyn putting a lot of pressure on me to take steroids for delivery. My hematologist wrote script for dexamethasone 20 mg a day for 4 days but he recommended I wait to take until 39 weeks since he's not worried about bleeding at my current levels. Going to the Gyno this week and they think I'm crazy...they are concerned about the possibility of needing section and going under general. Any advice would help. Anyone here took the risk and didn't take the steroids? Please tell me what your level was at delivery!!!! Nervous wreck here.

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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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9 years 7 months ago #44429 by Sandi
My two cents.....I am usually pretty conservative as far as treatment issues and don't like to see treatments used when they don't seem necessary. In this case, I agree with your Hemo that you'll probably be fine, but your OB is the one who needs to feel comfortable about the delivery. Many women cannot get counts to go up before delivery but you possibly can, so why not err on the side of caution? It wouldn't be a pleasant experience to do Dex right now, but it will be over and done and bleeding will not be an issue that anyone has to worry about.

Don't make yourself a nervous wreck over this. You got this far and this is a small bump at the end of the road!
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9 years 7 months ago #44437 by jillspeechpath
Replied by jillspeechpath on topic 38 weeks. Platelets 80,000. Steroids or no steroid
Hemo said to just take for the 4 days with no taper. What do u think about this??

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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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9 years 7 months ago #44439 by Sandi
That is how Dex is usually taken, with no taper. Normally it's a 40 mg dose for four days, so you're only getting half. The side effects are not pleasant and can be difficult for a few days after stopping the drug, but it might be worth it.
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  • Kelirae24
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  • I'm 31 years old and a mom to two awesome little boys, I was diagnosed with itp when I was 17 years old. With no treatment my counts are 0-5 I am currently on nplate and I had a splenectomy in 2004
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9 years 7 months ago #44475 by Kelirae24
Decision is totally up to you I'm 34 weeks pregnant and I would probably take it if it worked if I wanted an epidural the anesthesiologist told me my platelets would have to be in the 90s for c section they told me I need to be at 50 so depending on which route you wanna go it's your decision to make :) good luck :)
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9 years 7 months ago #44516 by jillspeechpath
Replied by jillspeechpath on topic 38 weeks. Platelets 80,000. Steroids or no steroid
Do the steroids work for you? What do you think you are going to do if they are below 90? Good luck to you also! What did they say they would do if for some reason they drop
Below 50 at the hospital on delivery day?

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  • Kelirae24
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  • I'm 31 years old and a mom to two awesome little boys, I was diagnosed with itp when I was 17 years old. With no treatment my counts are 0-5 I am currently on nplate and I had a splenectomy in 2004
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9 years 7 months ago #44593 by Kelirae24
No steroids don't work for me I am being treated with ivig three times a week now Bc my counts drop under 5 I am actually getting induced early to be sure my platelets are at a safe level I'm getting so nervous just hoping everything goes smoothly. My hematologist is confident with ivig we should be ok and worse case scenario platelet transfusions

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9 years 6 months ago #44819 by matkavlk0320
Replied by matkavlk0320 on topic 38 weeks. Platelets 80,000. Steroids or no steroid
I had my baby in 2009, but will be trying for #2 soon. I did steroids during my first pregnancy. They didn't work for me. I went in for delivery and my platelets were around 36, they had been around 28 most of the pregnancy. I ended up getting 2 platelet transfusions during delivery which finally got the count high enough for me to get an epidural. Personally, I hated steroids. If you can stay off of them during pregnancy that's awesome! There is even a new study out (not done in the US) that indicates steroids during pregnancy can cause attention deficit in children. I have no idea how legitimate the study is. It really depends on your doctor and what level they are comfortable with your numbers being at. If they drop below 50 on delivery day, I think a transfusion would be likely.

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