Many women with low platelets are concerned about having a family. A low platelet count does not prevent a woman from becoming pregnant or delivering a fine, healthy baby. However, the situation does require special attention and close coordination between the woman’s hematologist, obstetrician, and pediatrician.
Sometimes a low platelet count is discovered when a woman is pregnant. If that’s the case, it is important to determine if the low platelet count is associated with pregnancy (gestational thrombocytopenia) or due to another cause, such as ITP.
Treatment during pregnancy
If a woman has ITP and becomes pregnant, her platelet count may drop in the third trimester or she may relapse. However, treatments such as IVIg or prednisone can be given to raise the platelet count for delivery. Some treatments that are used for ITP, particularly those that suppress the immune system (except azathioprine) or stimulate platelet production, are not good options for pregnant women because they could harm the fetus.
Delivery
There is no evidence that a cesarean is safer for the baby in a mother with a low platelet count, so the decision to have a vaginal birth or cesarean should be based on the best method of delivery given the mother’s circumstances.1
Only a very small percent of babies born to mothers with ITP have low platelets at birth. Attempting to measure the platelet count of the fetus carries significant risk, so it is not advised. However, it is fine to do a cord blood count after delivery.2
FREE PDSA Publication
ITP and Pregnancy – Frequently Asked Questions (12 page booklet)
1. http://www.ncbi.nlm.nih.gov/pubmed/8857933
2. http://www.ncbi.nlm.nih.gov/pubmed/8309660
