ITP Warrior - Ashley H
At 30 years of age, I was diagnosed with ITP. I was in the 3rd trimester of my first pregnancy and my platelets were consistently around 120. Doctors told me that it was most likely gestational ITP. I had a safe delivery with healthy numbers. Right away after delivery my numbers started to plummet and started to camp out at 16. Two rounds of IVIG kept my numbers up to 80 for about 7 months and again a second time around. Then we moved to steroids till I was approved to start taking Promacta. My energy had returned and I felt great.
After 3 months of being on Promacta, My husband and I found out that we were expecting our second child. Right away, I was advised to stop taking Promacta. My numbers went back to 16 and I was hospitalized for a week. My hematologist at the time wasn't sure what to do, mostly because I was expecting. They decided to administer IVIG and once my numbers were above 50, they sent me home with a referral to see a specialist.
Right away, I met with an obstetrician who specialized in high risk pregnancy and ITP. She told me that I was refractory and needed constant observation. So she referred me to a hematologist that she works alongside with who also specialized in ITP and pregnancy. Together they came up with a few plans for me depending on what my body chose to do. For most of my pregnancy I was steadily on 20mg of Prednisone and received a half dose of IVIG every other week. This kept my platelet count around 60. I was admitted to the hospital 5 times throughout my pregnancy with numbers that dropped under 30 for reasons unknown.
Towards the end of my 3rd trimester the treatment wasn't keeping my numbers up for very long. To them this was no surprise. I was then admitted to the hospital at 37 weeks to be induced. They did not want me to go into spontaneous labor as it would be a risk with how unpredictable my numbers were. In the hospital, they administered 2 full doses of IVIG over 2 days. I had blood work done around the clock and once my platelet count was were they wanted them, it was go time. They gave me an epidural first before inducing me, which isn't typical but in my case they wanted to do so while my platelet count was good. I had a quick and safe delivery. And my son was healthy and thankfully he had normal platelet count. Throughout my whole pregnancy that was what I was worried about the most. With all the medication and treatment I received, I couldn't stop thinking about him being affected physically or neurologically because of my disease. There was a lot of worry, guilt and sadness time and again. I thank God everyday that he is well and so am I. I can't thank my team of doctors enough for being so diligent, supportive and understanding!
Afterwards I was grateful to be able to breastfeed my baby for two months with one round of IVIG in between. Then I had to stop and go back on Promacta. There is not a lot of information out there when it comes to Pregnancy with ITP. Everyone's journey is different. I hope that mine is helpful to someone somewhere who is experiencing ITP with pregnancy or looking to become pregnant! Godspeed.
PDSA Resources:
Podcast Episode 19 - ITP and Pregnancy: What You Need to Know Before, During and After
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