HELP AGAIN - What are my options now? Out of time.

I am almost 38 1/2 weks pregnant, and due to my ITP my OB is scheduling me for induction this coming Wednesday. My platelets on their own stay around 60-80k range, but we wanted an epidural to be an option so I started on steroids 2 weeks ago. 1 week after starting 80mg a day my platelets jumped from 60 range, to 97,000! We were happy.

Then, another week later, my platelets went back down to 49,000. Sigh. Not happy. I am going to see my hema Monday morning for a retest. She said some likely causes for the drop are: my OB office (who ran the last CBC) isnt experienced at looking at abnormal blood therefore they might have have a counting error due to clumped blood (and all machines are different), and also I am retaining a ton of fluid now that I'm at the end of pregnancy and that can play a role in the dilution of the test. She bumped my prednisone up to 100mg until Monday to see if I get a better read monday in her office with her machines.

Since I have until WEDNESDAY, can someone tell me what my options now are? I am really scared of being induced without an epidural. I've been given a 50% chance of needing a c-section also, so if the trial labor is too much for me it will be immediate c-section to avoid stress to me and baby. IF my platelets arent over 200k, I will be put to sleep during my csection. It is a trial labor because apparently with ITP patients my OB is not comfortable using forceps/vaccume if I need help during labor.

Anyway, From what I understand, IVIG might work between Monday and Wednesday to bump me up to better #s. And my OB mentioned platelet transfusion. Anyone have any experience with this? I am scared theres not enough time to do anything.

Help!

Hi,

I had my son 10 years ago and my ITP was awful at that time. I was in the ICU ward at the hospital getting IV's to keep him and I from bleeding. I'm happy to say..the magic number I had to look for was 70K for the epidural and with the help of predisone and some other steriod I made it..he was born 4 weeks early but was very healthy. They did a scratch test on his head to be sure his count was high enough to be born normally. I had a high risk OBGYN and my hemotogolist..and god..a great team. It's scary for sure but my son is healthy and does not have any signs of ITP. I wish you the very best and hope your body will come back around and increase the platlets.

Best wishes!

IVIG might work. The platelet transfusion would only be helpful if they used it during labor and close to delivery. There's also the chance that your counts could just go up between now and then.

I was induced without an epidural and made it through a 24 hour labor. Don't be afraid about that. It's rough, but I couldn't imagine it any other way.

I know you feel panicked right now and you want everything to go smoothly, but just breathe and put your faith in your doctors. You may not be able to control the situation the way you want it, but trust that the outcome will be the same - you'll have that little baby to hold.