33 Weeks with Plts 19,000

Hi, new here but not to ITP. I've been diagnosed since 2007 during my first pregnancy, and had my spleen removed last year (also ironically suffered a pulmonary embolism afterwards).

Anyway, I'm now 33 weeks pregnant with #3, and my platelets have dropped to 11,000. I have already been hospitalized a few weeks ago due to a nose bleed that wouldn't stop, and that's when they found out that my platelets were 11,000. I did a weeks worth of 100 mg Prednisone that bumped them up to 205,000, however after tapering off, my counts are back down to 19,000 as of last week.

My hematologist has already mentioned IVIG as a possible treatment again, although I'm against it because I get incredibly sick for weeks after each infusion. With my last 2 deliveries, I had steroids a week before delivery only, and delivered with a count of 69,000 spontaneously with my 2nd.

I'm not sure what treatment they're going to recommend when I'm closer to delivery, esp since I told them I'd refuse the IVIG. Has anyone else not had treatment prior to delivery or looked into alternative treatments? And yes, I do know the risk of refusing IVIG, although I'm not ruling out prednisone again.

Hi
I only get sick from IVIG if it is given too fast. If I get the big bottle I take the infusion for 7 hours. Anything less and the migraines and vomiting hit. Have you tried taking IVIG really slow? I prefer it than steroids.

Yes, I've been given the infusions over 2 days each time for 8-9 hours each and still get sick. Vomiting, migraines, muscle aches, etc. I've actually had a spinal tap after an infusion before that confirmed I had aseptic meningitis from it. Very rare, but my luck.

I wouldn't want that either. Sometimes having pre-meds prior to the infusion (such as Decadron) can help to avoid aseptic meningitis. Drinking lots of water the day before and the day of can also help. Not sure if you've tried that or not.

Yes, I have tried pre meds, several different kinds plus a lot of water. Thankfully though my platelets came up to 68,000 last week so my hematologist was ok with just doing 20 mg of prednisone for now.