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Hi everyone, first time poster here! I was diagnosed about a year and a half ago when I questioned some bruises that weren't healing. I was 29 and had always considered myself pretty healthy, had a 3 year old and 1 year old that I was still breastfeeding. So it was a shock, to say the least. My platelets were 15k so we did Prednisone which bumped me up to 120k, but a month later I dropped to 6k and was sent in for 3 days of IVIG. Since then I hover around 50k-80k and am now 25 weeks pregnant with my 3rd child (unplanned surprise!). I have been reading up on the discussion groups and have been researching more than ever. I think the first year I tried not to think about it too much as to not panic any more than I already was. This is my first pregnancy with ITP and I'm really trying not to over-think it but know I need to arm myself with knowledge! Should I be planning for a natural birth, just in case? My hematologist won't allow an epidural if under 100K and said closer to the due date we can dry to bring my counts up. But if for some reason it doesn't work maybe I should prepare for it? I also have Placenta Accreta where the placenta embeds into the muscle wall of the uterus instead of the lining and does not detach, therefore with both previous births they have had to scrape it off and work to control the bleeding. I worry about needing emergency c-section or surgery to remove placenta. Any advice or experiences are appreciated

Hi Emily - congratulations! I did not have ITP when I was pregnant with any of my three kids, but I can tell you this. I've been on this board daily since 1998 and have never seen a bad pregnancy outcome. Most of the time, counts are high enough for delivery due to treatments and things go smoothly. If counts are not in a good range, the doctors still manage to pull it off. Since you responded well to Prednisone and IVIG before, there's no reason to think that you won't the next time. It takes some planning to get the timing right, but it can be done.

As for the natural delivery, I did it twice (by choice) and yes, it was hard, but I got through it. Since this is your third, it will probably be the fastest one. I only had about 7 hours of labor with my third and spent most of that time at home. I got to the hospital an hour before he was born. The other two were a different story, but it usually does get easier. If you have to do it, you will!

I don't know anything about your placenta problem, but hopefully you have a good, high-risk OB who can guide you through.

Welcome Emily,
Congratulations on your third baby. I have had ITP since I was a child and am now 42, so I guess you could call me a lifer. I have three healthy boys (now 15, 13, and 11) that I delivered with my ITP. My counts weren't nearly as good as yours during my pregnancies (50-80 is great!), but everything went okay with crazy high doses of steroids throughout the pregnancies. The third trimesters were always a bit dicey because it was hard to get my counts much over 30, but we squeaked by.

I did have all three of the boys with natural births, but that was by choice. I may have been able to try to go the IVIg route to get counts high enough for an epidural, but I really didn't want that (all of my friends ended up with back pains and complaints from their epidurals, so my small sampling of anecdotal evidence was enough to convince me that I didn't want to try to go that route).
I absolutely loved it, and was especially glad to be experiencing my third birth that way because my third son was posterior and almost 10 pounds. I truly believe that there is no way that I could have pushed with the urgency required to get him out if I hadn't been feeling everything (I was successful and didn't need a c-section)! Hopefully your third child won't be such a naughty little stinker and will shoot right out (everyone told me soooo many times that the third birth would be so fast and smooth, and it almost always is! I was just lucky )

It sounds like things should go well for you and you'll probably just need closer count monitoring as you approach the end. Since you are responsive to prednisone and IVIg, you should have some easy treatment options to raise your counts prior to the big event.

I don't have any advice on the placental condition, but hopefully you have a good high risk ob/gyn. Keep us posted and enjoy the last half of the pregnancy!

Thank you so much for your reply, ladies! Just hearing your success stories (with ITP/pregnancy and natural births) puts my mind at ease. My Hemo tried to do the same but I'm a bit hard headed! I've always wanted to do natural births but never committed fully, thinking I will look into it more this go around.