Idiopathic Thrombocytopenic Purpura in Pregnancy
The following questions are for women who have discovered that they have idiopathic thrombocytopenic purpura for the first time in pregnancy.
Is it correct that a woman detected as thrombocytopenic means that she has ITP? The answer is no. During pregnancy the platelets count will drop about ten percent. This will develop thrombocytopenic in some women. Generally it is mild in nature and the women will be free from danger. This kind of thrombocytopenia is called by several names including gestational, benign thrombocytopenic of pregnancy.
How is ITP diagnosed during pregnancy? The diagnosis of ITP becomes complicated especially during pregnancy because other reasons of thrombocytopenia are more widespread and not easy to detect as well. ITP will be detected any time during pregnancy when thrombocytopenia of less than 50000 ppm is identified particularly during the first two trimesters. The physician will carried out several tests to ground the causes of low platelets. It depends upon the symptoms and how low the platelets count drops.
In some cases, the physician will test to find out the presence of anti-platelet antibodies. They will order tests for other disorders such as lupus and a bone marrow aspiration. When the physician cannot make an absolute diagnosis of ITP during pregnancy and when no other cause is found for very low platelet count then the diagnosis is always ITP. There is no authoritative test for ITP and to distinguish ITP from gestational thrombocytopenia.
Is it compulsory for a woman with gestational thrombocytopenia to seek the care of an obstetrician or hematologist? Usually, a woman with serene gestational thrombocytopenia will not have need of a high-risk specialist. However, distinguishing gestational thrombocytopenia from ITP during pregnancy is not easy, so it is advisable to consult the physician regarding the requirement for special care.
What is the likelihood that the baby born to a woman with gestational thrombocytopenia will be thrombocytopenic? There are no incidences that women with gestational thrombocytopenia will deliver thrombocytopenic newborns. The mother’s platelet counts will return to normal within two months subsequent to delivery.
Thus we have seen a questionnaire regarding those women who have ITP for the first time during pregnancy. Below are some questions for pregnant thrombocytopenic women whether or not they were diagnosed with ITP.
Is there a healthy platelet count to be maintained during pregnancy to responsible for the well being of the mother and fetus? There is a medical record that says a platelet count of 50000 ppm or higher will be safer for the pregnant woman and fetus as well. Physicians mostly prefer to not to treat ITP during pregnancy if the platelet count stays at or above this level. In fact, most physicians limit the platelet count level above 20, 000 ppm during pregnancy. Some physicians raise the bar to 50, 000 ppm and above and between 80,000 and 1, 00,000 ppm for a regional anesthesia.
May a woman with thrombocytopenia have a natural delivery? The answer is yes. There is no reason why gestational thrombocytopenia or ITP should prevent a vaginal, natural delivery. A number of incidences depict natural deliveries where the mother’s platelet count is below 20,000 ppm with no complications or setbacks for the mother or child. For the sake of the mother and child, several physicians opt for a platelet count of above 50, 000 ppm at delivery in case a C-section is required for obstetrical reasons.
Till date, C-sections were suggested for women with ITP because it was considered a safe and reliable way as compared to a vaginal birth. However, several incidences have taken place that point towards the risk of C-section over the vaginal delivery for the mother. The manner of delivery must be made on the basis of obstetrical conditions and not on the basis of the ITP.
Thus it is advisable to consult a physician if a woman has idiopathic thrombocytopenic purpura in pregnancy.