Doctors seem to be good at making moms-to-be worry. The other week, I chronicled my pregnancy with my first daughter and our concerns about ventriculomegaly and hydrocephalus. In the end, it all worked itself out and my daughter was born with no health issues.

Several years later, my pregnancy with my second daughter went more smoothly. She had no major health concerns. However, after a routine round of blood work at 8 weeks, my doctor told me my blood platelet count was slightly below normal. The medical term is gestational thrombocytopenia.

To put it simply, platelets play a key role in helping blood to clot, so a person doesn’t bleed too much. The normal range is about 150 to 400 million per milliliter of blood. My platelets were only a little low, at about 140. They drew blood again early in my second trimester, and platelets still hovered around 140.

It’s common for pregnant women’s platelet counts to drop a little, and thrombocytopenia affects around 8 percent of all pregnancies. It doesn’t cause symptoms unless platelet levels are extremely low, around 50 or lower, and then women are at increased risk of bleeding. Often, thrombocytopenia happens simply because of increased blood volume during pregnancy. It can have other less common causes, too, such as preeclampsia or an autoimmune disorder.

I wasn’t very worried. I figured my doctor knew what to do, and she wasn’t panicking. I was safe, and so was my baby. I did some Googling at home and found only one thing that concerned me. Apparently, if a pregnant woman’s platelet count dips too low, she may not be allowed to get an epidural. I had already been steeling myself for the possibility of forgoing the epidural anyway, because women in my family have a history of very, um, efficient
labors and deliveries. In the back of my mind, I knew it was conceivable for me to have a two-hour labor and no time for pain relief. If my platelet count sank too low, that would just seal the deal.

Sweet Daughter #2, just hours after her birth.

When I had my one-hour glucose test toward the end of my second trimester, they drew an extra vial of blood to recheck my platelet count. It had finally bumped back up into the normal range, and my doctor said she didn’t think my counts were going to trend downward for the remainder of my pregnancy, so she let the matter drop.

My second daughter was born after five hours of labor with an epidural. It probably would have been four hours without the epidural. I didn’t bleed to death, and I got some good pain relief, so it all worked out well.

Still, it seems like if it isn’t one thing it’s another. I know doctors are being diligent, and if there was a serious problem, I’d want to know. If I ever have a third baby, though, I’ll be prepared for some other obscure condition to fuss about during pregnancy. They always find something.

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Category: Health

Tags: bleed