Thrombocytopenia (Low Platelet Count) During Pregnancy

What is Thrombocytopenia

Platelets are responsible for blood clotting and play a significant role during pregnancy as well. The average or normal platelet count of a non-pregnant woman may range between 150,000 and 400,000 per microlitre of blood. The platelet count of a woman may drop to 116,000 per microlitre of blood during pregnancy. However, if it is less than 116,000, the condition is known as thrombocytopenia.

If there is only a slight drop in your platelet count, it is not a matter of great concern as it may not cause any medical complication for you or your baby. Though, your platelet count will be monitored closely by your doctor or midwife to see if there is a further drop. However, extreme drop in your platelet count may cause serious problems and therefore will require immediate medical help.

How Common is Thrombocytopenia during Pregnancy

Thrombocytopenia or low platelet count during pregnancy is the second most common blood disorder after anaemia. It is observed that nearly 5 to 8 percent women may get diagnosed with a low platelet count during their pregnancy. Not all cases of thrombocytopenia may cause serious complication in pregnancy or childbirth, but it is better to prepare yourself to face any complications that may arise with this condition.

What Causes Low Platelets Count during Pregnancy

Following are some of the causes of low platelet count in pregnancy:

• High Blood Pressure or Preeclampsia: When your blood pressure reaches alarming levels in pregnancy it puts you and your child at risk. The risk involves damage to the organs of both mother and her unborn child. This condition may also cause low platelet count in a pregnant woman.

• Heparin-Induced Thrombocytopenia: Heparin is a medicine used to treat abnormal blood clotting. Sometimes the use of this medicine may result in low platelet count and this kind of thrombocytopenia is called Heparin-induced thrombocytopenia.

• HELLP-Haemolysis of Red Blood Cells Elevated Liver Enzymes and Low Platelets: This medical condition results from high blood pressure which may cause severe damage to the liver. The damage to the liver leads to platelet to drop resulting in thrombocytopenia.

• ITP or Immune Thrombocytopenic Purpura: This is an immune-mediated disorder which leads to a decrease in the platelet count of the body. In a primary ITP, the exact cause of immune destruction cannot be established, whereas the reason for immune destruction in secondary ITP may be caused because of Hepatitis C or SLE.

• Medicine Induced: There are many medicines that may hamper the platelet production. Some common drugs that may be used in pregnancy, such as, ibuprofen, paracetamol etc can affect the platelet formation in the body, resulting in thrombocytopenia.

• Systemic Lupus Erythematosus (SLE): This is an autoimmune disorder in which the body attacks itself. Pregnancy may elevate the chances of SLE by forming antibodies that destroy various organs. It may target bone marrow, which is responsible for platelet formation. The affected bone marrow may cause low platelet count.

• Cancer: A pregnant woman may be affected with Myelodysplastic syndromes and lymphoproliferative syndromes. These are the common types of cancers that may affect a pregnant woman resulting in low platelet count.

• DIC Or Disseminated Intravascular Coagulation: This disease can be caused due to various pregnancy-related medical conditions. This condition may cause widespread clotting in the body. The clotting may result in low platelet count.

• Aplastic anaemia: This blood disorder in pregnancy may result in complete destruction of the red bone marrow resulting in low platelet count.

• HIV/AIDS: HIV is an immune disorder that may also affect a pregnant woman. This infection causes destruction in the bone marrow. When HIV causes destruction in the bone marrow, it results in low platelet count.

What Happen if You Have Thrombocytopenia

If you have thrombocytopenia before pregnancy, there is a fair chance that it is caused due to some existing condition or medication that you may be taking. This condition can be determined through an early pregnancy test as there is no specific diagnostic test to determine the cause of low platelet count in the body. Your doctor will monitor your condition regularly to check for any symptom of the underlying cause or to check any further decline in the platelet count.

If the low platelet count is established in the later stages of pregnancy, then it may due to various reasons such as preeclampsia or HELLP syndrome. You will be treated according to the symptoms of your condition.

In case of gestational thrombocytopenia, you are unlikely to require any treatment. However, your doctor may keep a constant tab of your health.

Risks of Low Platelet Count during Pregnancy

The major risk associated with low platelet count in pregnancy is the increased risk of bleeding during the childbirth or post that. There is an increased blood supply to the uterus during pregnancy and the surgical procedure requires cutting of major blood vessels. Women with thrombocytopenia are at increased risk of losing excessive blood. The risk is more in case of caesarean delivery as compared to vaginal delivery.

If a woman with thrombocytopenia requests for an epidural then she may be at a risk of spinal epidural hematoma, a condition which can be caused by an accidental puncture in the spine. This condition may lead to permanent paralysis also.

Treatment for Pregnancy Low Platelet Count

The treatment for low platelet count in pregnancy depends on the severity of your condition. Milder conditions usually do not require any medical intervention but may require constant monitoring by your doctor. However, the severe cases will require a proper treatment. The treatment will involve treating the medical condition (preeclampsia, HHELP, SLE etc) which is causing the platelets to drop.

How to Increase Low Platelet Count Naturally

You may increase your low platelet count by following natural methods:

1. By including beetroot in your diet.
2. By including fish and meat in your diet.
3. By consuming astragalus (herb).
4. By adding zinc supplements
5. By consuming vitamin B-12, generally found in meat
6. By consuming Vitamin K, generally found in green leafy vegetables
7. By consuming chlorophyll
8. By consuming Vitamin C rich food ( citrus fruits )
9. By avoiding alcohol and refined sugar

Though consuming foods that may help increase your platelet count may seem like a good idea, but it is recommended to seek your doctor’s advice before making any dietary changes.

Though most cases of thrombocytopenia do not pose a serious threat to you or your unborn child, however, if you have been diagnosed with this condition, it is important that you get the apt treatment for the same. Timely detection and treatment of your condition will reduce the chances of complications.