Low Platelets During Pregnancy – Causes, Symptoms and Treatment

Pregnancy is a time when the body produces more blood plasma that increases the volume of blood and even hemodilution. Hemodilution indicates the same amount of blood platelets in larger blood volume which is also the reason for the platelet count per microlitre to reduce. It could even go down as the cells get destroyed due to increased blood volume of the spleen.

Common causes of low platelets during pregnancy are given as under:

1. Fatty Liver

This condition is rare but a serious one. Acute fatty liver is a condition where the platelet count can go down below 20,000 for every microliter of blood.

2. Hypertensive Disorders

Low platelets during pregnancy are also due to disorders like HELLP, preeclampsia, etc. This is a reason and is seen in 20% of cases.

3. Immune Thrombocytopenic Purpura

Immune thrombocytopenic purpura (ITP) is an autoimmunity disorder. This is due to the destruction of the platelets in the spleen. Immune thrombocytopenia is one of the most common reasons for platelets to go down in the first trimester of pregnancy.

4. Other Reasons

Having nutritional deficiency ( folate and B12), and a few other causes are given as under:

• Bone marrow disease
• Alcohol abuse
• Bacterial infection
• Cancer
• Anemia
• Chemotherapy
• Viral Infection ( CMV and HIV)
• Medications
• Viral infection

Symptoms of Low Platelets During Pregnancy

Most of the pregnant women who have thrombocytopenia or low blood platelets during pregnancy do not show any symptoms or are asymptomatic.

Some women however show a few symptoms like:

• Fatigue
• Blood in the stool or urine
• Getting bruises frequently
• Tiny red spots under the skin
• Brown or red bruises
• Bleeding resulting from gums due to brushing and flossing
• Nose bleeding
• A Bleeding due to a cut

What Are the Complications of Thrombocytopenia During Pregnancy?

If the blood platelet count falls low during pregnancy and is consistent till delivery takes place, it might lead to many other complications for the mother and the baby which is not good. Some such complications are:

• One can have heavy blood loss at the time of delivery or post-delivery.
• Inability to have epidural anesthesia prior to delivery also known as epidural hematoma.
• If the woman has a history of low blood platelets, she can have persistent gestational thrombocytopenia.
• Maternal thrombocytopenia can also affect the fetus.

Besides these, the other complications can be :

1. Uremic Syndrome

A condition in which the tiny blood vessels in the kidneys either get inflamed or get damaged.

2. Hemolytic Syndrome

A condition that can affect the blood vessels and the blood. This can result in improper functioning of the kidneys.

3. Disseminated Intravascular Coagulation

A condition in which there are blood clots all over the body resulting in multiple organ damage.

[Read : What Is An Epidural?]

Top Treatments For Low Platelets During Pregnancy

There are many causes for the occurrence of thrombocytopenia. The patient is treated as per the underlying cause. Not all causes need treatment, some which are severe in nature require a specific type of treatment. A pregnant woman who needs treatment also requires multi-disciplinary care combined with a hematologist as well.

A few options for treatment for thrombocytopenia during pregnancy are as below:

1. Blood or Platelet Transfusions

In case of emergency or cesarean delivery, blood transfusions are done. It can also happen when the platelet count goes below 50,000 for every microliter.

2. Oral Prednisone

Drug Prednisone is the first line of treatment for a pregnant woman who is suffering from thrombocytopenia. Even though this is safe during pregnancy, but few studies indicate that it might have harmful effects like gestational diabetes.

[Read : Gestational Diabetes]

3. Plasma Exchange

As per research, plasma exchange therapy is another way to treat thrombocytopenia.

4. Intravenous Immunoglobulin (IVIg) and Other Corticosteroids

Studies indicate that corticosteroids and intravenous immunoglobulin are also treatment options for pregnant women with ITP.

How to Prevent Low Platelet Count During Pregnancy?

Prevention of Thrombocytopenia is not easy yet it can be managed well if some precautions are taken. A few such measures are:

• One should avoid taking supplements, medicines, or any home or natural remedies without consulting a doctor. This might result in bleeding or can even affect the number of platelets.
• The doctor must be made aware of any family history of thrombocytopenia. This helps them to advise proper medication and to avoid any medicines as well.
• It is advisable to not get into any strenuous activities or contact sports which might end up in bruises or injuries.
• Do not take alcohol as it increases the risk of production of low platelets and can even damage the liver.
• It is important to gently brush the teeth, blow the nose, avoid any form of bleeding, and even shave.
• It is important to avoid any kind of exposure to chemicals, or pesticides as even they can drop the platelet counts in many cases as they are very strong.

Home Remedies to Increase Low Platelet Count

Having specific foods during pregnancy helps to boost the platelet count and enhance health. This however does not indicate that a doctor’s visit or any treatment or cure can be avoided.

Some natural remedies that are helpful in increasing the low platelet count are :

• Vegetables and fruits like carrots, berries, tomatoes, beetroot, etc.
• Green leafy vegetables like kale, spinach, fenugreek, etc.
• Vitamin C-rich foods like broccoli, sprouts, lemon, etc.
• Lentils, eggs, beef, liver, and fortified cereals.
• Dark chocolate, walnut, peanut, and other rich dairy items.
• Omega 3 Fatty acids rich foods like flaxseed, fish, etc.

[Read : 6 Amazing Reasons Why Women Need To Eat Chocolates During Pregnancy]

When Should You Meet a Doctor?

It is important to meet the doctor only if there are any signs of thrombocytopenia that are worrisome. The most important is bleeding that does not stop even with regular first aid etc. Consistent bleeding is a sign of an emergency.

Thus, thrombocytopenia is common during pregnancy and dies not to have serious complications for the mother or the baby. However, it is still advisable to keep the doctor informed so that he can regulate and keep a proper check.

Read Also: Blood Clots During Pregnancy