Low blood count in early pregnancy

Low Platelet Count During Pregnancy

24.09.2016 Andrew Johns 0 Popular

Low Platelet Count in Pregnancy: Causes, Symptoms and Treatment

Platelets (PLT) are the smallest blood cells produced by the bone marrow. They participate in blood clotting. The continuous clotting in the body destroys about 40% of circulating platelets per day. The life expectancy the platelets have is only 7-10 days.

Normal Platelet Count in Pregnancy

Platelet count during pregnancy remains practically unchanged. Normal platelet count in non-pregnant women is within the range of 180-320/10 l. However, pregnant women may have a slightly lower normal level of platelets.

What are the Reasons for Platelets Count Lowering in Pregnancy?

Thrombocytopenia or critical reduction of platelets in the blood analysis can be caused by several factors:

However, Thrombocytopenia in pregnancy may occur without these reasons and, as a rule, this does not lead to any serious complications. Standard techniques used to increase the number of platelets in the blood may vary depending on the case severity.

Very low platelets count in the analysis is can indicate at unstoppable bleeding in a patient, this is the threshold beyond which Thrombocytopenia is transformed into a real problem. In this case, if the platelet count drops below 100,000 units per µL, the medical staff of maternity hospitals normally refuses to provide an epidural or a cesarean section.

In fact, a non-critical level of platelets in pregnancy can be caused by trivial malnutrition or improper diet of the future mother. The following guidelines are to help pregnant tackle this problem.

What are the Ways to Increase the Level of Platelets During Pregnancy By Using Proper Nutrition?

This is primarily erianthous milkvetch (Astragálus dasyánthus), which is a very common means to elevate the number of platelets. This has been proven by the research activities aimed to reduce the chemotherapy damage. This herbaceous plant has the ability to significantly increase the number of platelets in the blood.

All pregnant women should increase the intake of vitamin C during childbearing to exclude the unwanted shortages and problems related. Citrus diet containing large amounts of vitamin C should be doubled. Raspberry is another great source of vitamin C. Raspberries are better be served fresh or mashed with sugar.

Zinc is a mineral needed by all pregnant women without exception. Zinc deficiency in the mother-to-be often results in pathologies of the fetus and congenital deformities. In addition, zinc deficiency is also associated with a decrease in platelet count during pregnancy; while adding zinc in the diet causes a sharp increase in platelets developed by the bone marrow. This list includes beets, meat, fish and Vitamin B12.

Thrombocytopenia in Pregnancy and its Treatment

Platelets represent fragments that derive from the destruction of megakaryocytes. These giant cells dwelling in the bone marrow originate a large number of small and flat particles. Normally, their concentration in 1 l of blood is about 200-300*109. Thrombocyte lifetime does not exceed seven days, and then it is utilized in the liver or spleen.

Protection, which is the main function of platelets, is realized due to a blood clot formed at the site of damaged vessel. In addition, these tiny cells contribute to the nutrition of the inner surface of arteries (intima) providing its elasticity and resistance to external damage. Platelet deficiency can be associated with a slowed formation, intensive destruction or uneven distribution. The latter case deals with the platelets normal in total number, but concentrated in certain areas of the vascular bed, while lacking in other areas.

Thrombocytopenia in pregnancy is common occurrence and there are several reasons for this:

  • Hormonal modifications decrease the lifetime of platelets;
  • Increased volume of circulating blood may reduce the relative quantity of platelets;
  • Poor nutrition and related folate and B12 deficiency;
  • Nephropathy during pregnancy, preeclampsia, eclampsia;
  • Viral infections;
  • Autoimmune thrombocytopenia developing due to the activation of the immune system against its own blood cells;
  • Allergic reactions and systemic diseases;
  • Various obstetric haemorrhage (Placental Abruption);
  • Intrauterine fetal death;
  • Intake of drugs (antibiotics) and intoxication.

Low red blood cells and platelet count may be physiologically insignificant (no less than 100*109).

Usually, this condition does not manifest itself and is found at a routine examination. In this case, treatment is not required, but it is necessary to control the analysis. In the case of pathological thrombocytopenia, it is necessary to specify the underlying cause and begin treatment. Otherwise serious complications may occur.

Main Symptoms and Dangers

Symptoms of thrombocytopenia in pregnant women are somewhat more diverse than those in regular patients. Symptoms in women:

  • Bruises caused by touching, sometimes they are formed without external influences;
  • Bleeding nose and gums, but the latter is not always specific, since gingivitis pregnant develops in many women without deficiency of platelets in gestation period;
  • Gastro-intestinal bleeding, including hemorrhoids and fissure;
  • Dotty hemorrhages (ecchymosis)on the limbs and anterior surface of the trunk;
  • Vaginal bleeding.

Untreated thrombocytopenia can lead to serious complications of the pregnancy and delivery process. The most dangerous is massive bleeding, which can result in patient’s death. In addition, during the autoimmune process, antibodies penetrate the placenta into the bloodstream of the fetus. In this case, the newborn may develop thrombocytopenia.

Methods of Treatment

The disease treatment turns indispensable at a platelets count less than 20-40*109 in l. Along with the therapy of the underlying disease, which has led to a shortage of platelets, the hemostasis system must be maintained as well.

The drug of choice in this case is the glucocorticoids (prednisolone, dexamethasone). In late pregnancy, they also speed up the formation of the baby’s lungs. Therefore, if there are special indications, the doctors may hold a premature delivery. Short courses of corticosteroids are used to treat thrombocytopenia, the dosage is reduced gradually if the clinical effect is achieved.

If corticosteroids are not effective, the doctor may prescribe intravenous administration of immunoglobulin. It is injected 3-4 times during pregnancy and then during and immediately after the delivery. Quite rarely, in urgent cases a pregnant woman may undergo a platelet transfusion.

If all of the mentioned above medications are ineffective, a pregnant woman may have her spleen removed (a surgery called splenectomy). It is advisable to perform the operation through the laparoscopic access.

The type of delivery is to be discussed individually, but it’s better to conduct a planned C-section in order not to harm the baby. This is especially advisable for the newborns with a low platelet count.

Thrombocytopenia affects 1-2 % of pregnant women, in 70 % of cases this condition is caused by changes the body undergoes after the conception. The causes of this disease are quite diverse, but the most dangerous is the immune mechanism. This is explained by the fact that the pathology may transfer to the baby, and thrombocytopenia in newborn babies often leads to serious complications. At early stages the disease goes asymptomatic, that’s why it is so important to pass blood tests regularly.

Low Platelets During Pregnancy (Thrombocytopenia)

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    Platelets are little particles found in human blood that help seal cuts on the skin by giving other clotting proteins a chance to stop the bleeding. A normal platelet count measures between 150 and 400 million per milliliter of blood. Pregnancy brings visible and hidden changes to women’s body; therefore, doctors take precaution and test the blood of expecting mothers three times, once in initial blood work, with glucose test and at the delivery. Eight percent of women experience a slight drop in their platelet count that is usually between 100 and 150 million of platelets per ml of blood.

    Should You Worry About Low Platelet Count in Pregnancy?

    Women whose platelet count during pregnancy slightly defers from the normal criteria shouldn’t be worried. Specialists in such cases always keep an eye on the patient by monitoring the current status. The condition where platelet count plummets down below normal concentration is referred to as gestational thrombocytopenia. This condition usually occurs in the third trimester and doesn’t affect the baby’s well-being. After the delivery, the levels of platelet in your system will gradually become normal once again.

    If you are wondering why the levels of platelet decrease during the pregnancy, well, the world still doesn’t know the precise answer. Experts have determined these two factors that may have an impact on internal balance.

  • The human body naturally disintegrates platelets if they are not active and supplants them with the new share. During pregnancy, the process of disintegration is much quicker. Therefore high levels of small platelets are now replaced with low count consisting of larger particles.
  • During pregnancy, the human body produces higher amounts of plasma, which is a fluid part of the blood. Because the level of fluid is higher, the blood naturally becomes more diluted and with that, the concentration of platelets reduces as well. However, the platelets (thrombocytes) don’t lose the functionality because of the dilution.
  • The blood test results are always written in maternity notes and are stated in this from: “Plat. 155×10.9/L”, which means an individual has a count of 155. If your platelet level is below normal, you should know that bleeding during or after the labor is possible.

    Other Causes of Low Platelet Count During Pregnancy

    Sometimes the cause of abnormally low platelet count has very little to do with the pregnancy; therefore the origin of such condition probably lies in preexisting condition, such as lupus. Some medicines, such as heparin can also be a cause of low platelet count in pregnancy.

    Immune Thrombocytopenia

    Immune Thrombocytopenia (ITP) is a chronic medical condition that usually occurs after a viral infection in childhood and continues into the adulthood. To simplify the impact of ITP on a human body, we could say that the immune system attacks perfectly healthy platelets. This immune condition is treated with steroids when the count drops below 50.000 per ml of blood. In the case of immune thrombocytopenia, platelet transfusion is not an option, because the body destroys the foreign thrombocytes as well. Before the actual treatment, the illness has to be firstly diagnosed. The ITP is usually recognized before pregnancy but if not, an expecting mother shouldn’t worry, because the initial pregnancy blood test determines the current state of the body. The delivery itself is usually executed by cesarean section because there is 10% possibility of a baby having immune thrombocytopenia as well.

    Pre-eclampsia

    Pre-eclampsia is a disorder that evolves during the pregnancy characterized by high blood pressure and protein in the urine. Low count of thrombocytes can be a sign of a severe form of pre-eclampsia also known as HELLP syndrome. HELLP syndrome is usually noticed in the third trimester and requires immediate delivery. Even if a mother suffers from such condition, the baby’s level of platelets remains normal. HELLPS syndrome doesn’t leave permanent effects on women because the levels of platelet return to the normal range shortly after the delivery.

    Treatments for Low Platelet Count in Pregnancy

    Treatments differ based on the cause and intensity. Gestational thrombocytopenia requires no remedies outside of regular blood draws to monitor the platelet level. The treatment for immune thrombocytopenia starts when the level of thrombocytes falls below 50.000. The regimen includes steroid intake to suppress the immune system from destroying perfectly functional platelets. The steroids cause remission of symptoms in 25% of patients while 66% of people experience the improvement of low platelet counts. Hypertensive conditions such as pre-eclampsia and HELLP syndrome are not treated with specific remedies, only with the delivering of a baby. In all mentioned cases, except the ITP, the low platelet count rerun to normal range within 3 days of delivery.

    HELLP Syndrome During Pregnancy

    HELLP syndrome in pregnancy is a grievous and critical obstetric situation usually regarded to be a version of an abnormal state of pregnancy characterized by hypertension and fluid retention and proteinuria.

    HELLP is a shortened form of a word of the following:

    • Hemolytic anemia or hemolysis (Anemia resulting from destruction of erythrocytes)
    • Elevated Liver enzymes and
    • Low Platelet count.

    Hellp syndrome in pregnant women must be treated as early as possible and depending on the security of the symptoms, it is important to induce labor in order to prevent serious and lasting consequences including irreversible liver damage.

    Treating HELLP syndrome in pregnancy

    Hellp syndrome during pregnancy can only be effectively treated by inducing prompt delivery of the baby. A number of medicines have been looked into for the handling of HELLP syndrome in pregnant women, but evidence is contradictory over whether the administration of magnesium sulfate diminishes the chances of an epileptic seizure and instead advances towards eclampsia, which is a toxic condition characterized by convulsions and possibly coma during or immediately after pregnancy.

    Immediately after delivery, the patient may treated with fresh frozen blood plasma to fill up the clotting proteins, while the anemia may call for the introduction of blood in the body. In moderate cases, steroid hormonal medications and drugs that reduce high blood pressure may be administered. Administration of nutrients through a vein is also needed on order to supply the body with essential nutrients and to help in building the platelet count levels. In the event of life threatening bleeding, hepatic hemorrhage is handled with embolization.

    Symptoms of HELLP syndrome in pregnancy

    When a pregnant woman starts to display symptoms off preeclampsia, the doctor usually recommends additional testing to rule out the incidence of Hellp syndrome. Blood testing is usually done to keep a tab on the liver enzymes and the platelet count. Patients with the syndrome experience severe fatigue and intense tiredness. Other symptoms pointing to the disorder include pain in the upper right part of the stomach.

    The woman may also experience unmanageable headaches and feelings of nausea and vomiting. One may also experience swelling, especially on the face and the hands. In rare situations, there may be noticeable bleeding from the gums. The syndrome may be difficult to detect as most healthy pregnant women experience these symptoms unrelated to the disease late in pregnancy, hence it is not easy to know for sure if the patient is experiencing HELLP syndrome.

    По материалам:

    Http://infobaby. org/low-platelet-count-pregnancy/

    Http://www. edisonentrepreneurship. eu/acidreflux-edis/hn14151-h-pylori-and-low-white-blood-cell-count-ulcer-back-do-pain-causes/

    Http://www. newhealthadvisor. com/low-platelet-count-in-pregnancy. html

    Http://www. pregnancy-baby-care. com/conditions-during-pregnancy/hellp-syndrome-pregnancy. html

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