Gestational thrombocytopenia is usually mild and often resolves on its own after birth.
This article will cover the symptoms, causes, and complications associated with low platelets in pregnancy.
Throughout pregnancy, the number of platelets in the blood naturally goes down.
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In people with gestational thrombocytopenia, the platelet count always returns to normal within a few weeks of delivery.
Hemodilution means you have the same number of platelet cells in a larger volume of blood.
As a result, your platelet count per microliter of blood goes down.
During pregnancy, your spleen gets bigger because of the increased blood volume.
When theenlarged spleenfilters your blood, it may destroy platelet cells at a higher rate.
Rarely, a severe lack of folic acid in your diet can also lead to thrombocytopenia.
It does not cause bleeding problems and is generally not associated with a higher risk of pregnancy complications.
The level continued to go down, with the average platelet count at birth being 217,000 platelets.
What Is a Normal Platelet Count?
A normal platelet count ranges from 150,000 to 450,000 platelets per microliter of blood.
When your platelet count is below 150,000 platelets, you are considered to have thrombocytopenia.
Gestational thrombocytopenia usually begins mid-pregnancy and gets worse as the pregnancy goes on.
It then gets better on its own within one to two months of giving birth.
Its estimated that 70% to 80% of cases of thrombocytopenia during pregnancy are due to gestational thrombocytopenia.
If a persons platelet count falls below 100,000 platelets, ITP is more likely to be the cause.
With gestational thrombocytopenia, bleeding problems rarely happen.
In that case, extra precautions might be necessary to prevent bleeding during delivery and after you give birth.
The treatment will depend on your platelet counts, your health, and the health of your pregnancy.
You may need to get medicine through an IV in the hospital, including steroids and immunoglobulin.
Other treatment options likemonoclonal antibodiesandimmunosuppressantdrugs have also been explored.
In more severe cases, you may need a transfusion or surgery to take out your spleen.
The condition usually occurs after the 20th week of pregnancy.
For people at high risk, daily low-dose aspirin might be recommended to help prevent preeclampsia and its complications.
The treatment should be started between 12 to 28 weeks of pregnancy, preferably before 16 weeks.
The treatment for preeclampsia usually includes a medication called magnesium sulfate.
Summary
Gestational thrombocytopenia is usually a natural part of pregnancy.
Gestational thrombocytopenia is sparked by the natural changes occurring in your body during pregnancy.
When you are expecting, your body increases its blood volume, causing hemodilution.
This shows up when the blood plasma increases while the number of platelets remains the same.
This leads to a lower platelet count per microliter of blood.
In addition to hemodilution, an increased blood volume causes the spleen to become enlarged.
When this happens, the enlarged spleen traps and destroys more platelet cells during the filtering process.
No, gestational thrombocytopenia does not pose a risk to you or your baby.
Reese JA, Peck JD, Deschamps DR, et al.Platelet counts during pregnancy.N Engl J Med.
2018;379(1):32-43. doi:10.1056/NEJMoa1802897
Cines DB, Levine LD.Thrombocytopenia in pregnancy.Blood.
2017;130(21):2271-2277. doi:10.1182/blood-2017-05-781971
MedlinePlus.Thrombocytopenia.
ACOG Practice Bulletin No.
207:Thrombocytopenia in pregnancy.Obstet Gynecol.
2019;133(3):e181-e193.
doi:10.1097/AOG.0000000000003100
Gernsheimer T, James AH, Stasi R.How I treat thrombocytopenia in pregnancy.Blood.
McIntosh JJ, Reese J, Deschamps D, et al.69: Defining gestational thrombocytopenia.Am J Obstet Gynecol.
2018;218(1):S50-S51.
doi:10.1016/j.ajog.2017.10.480
Johns Hopkins Medicine.What are platelets and why are they important?
Park YH.Diagnosis and management of thrombocytopenia in pregnancy.Blood Res.
2022;57(S1):79-85. doi:10.5045/br.2022.2022068
MedlinePlus.Preeclampsia.
2021;326(12):1186. doi:10.1001/jama.2021.14781
Jin J.Use of aspirin during pregnancy to prevent preeclampsia.JAMA.
2021;326(12):1222. doi:10.1001/jama.2021.15900
MedlinePlus.Platelet tests.
