ITP in third trimester is stressful!!

So here's my story...

I was diagnosed as a child. And my ITP never affected my life in anyway thereafter, until...

I got pregnant with my first Son in 2009. Suddenly, the platelets plumitted. By the third trimester, they were at 20,000ish, and on a steady decline. Baby was due November 13th. My Doctor (and earth angel!!) prescribed me IVIG treatment - October 13th, and 14th. Monday October 19th, I got the call: "Platelets are at 155,000". Michael (my Son) broke my water that night, after hearing that Mommy's platelets were ready for him. The perfect luck.

So, we're waiting for our second now, another Boy, due April 15th, 2011. Platelets have been dropping again. Started IVIG in January - my sixth treatment begins this Tuesday. The IVIG hasn't been consistent. Most times, it gets my levels up, but on two occasions, failed to do so. Last week's treatment was a total waste. Brought them up to 89,000, which is good on a given today, but will decline rapidly within 3 days. After IVIG, my platelets generally peak at about 140,000 shortly after treatment, then drop 20,000 per day or so. I am praying that the IVIG failed because I have a cold (which can affect platelet counts). I pray that I have not developed a tolerance to the treatment.

I am 35 weeks and 2 days!! My first born was due a month early... My Doctors agree that this one is ready - only problem, he's breech!!!! My Doctors expect a count of at least 50,000 for deliver, and delivery options for me are:

If platelets are below 80,000:
Vaginal delivery, no epiral, if baby turns.
C-section, under general aneastesia, if he remains breech.

If platelets are above 80,000, and epidural is possible in either situation.

I have the best Doctors, and have full faith in them. I honestly don't think I could be in better hands... But the truth is, I am still scared. I know that as I write this, my levels are below 80,000, perhaps even 50,000, the baby is breech, and I can't help but worry that my water will break. I would hate to be put to sleep for a c-section, and miss out on those first few hours. Even Daddy would not be able to be in the operating room. And the thought of waking up, and wondering where he is, and if he's ok...

I try to remain positive, and don't share my fears with my family (mainly because I don't want to scare them).

IVIG in 3 days!!! Then the levels will be up again... Doctors will be inducing (or c-section) this week or next. Will keep you all posted.

We need to remember - our disorder is MANAGEABLE. I truly feel so blessed that people donate blood, not to save my life, but to allow me to have children. Words cannot express my gratitude.

I feel your stress. Im 37 weeks today (yeah almost done) but on Friday my counts dropped down to 26, and I had IVIG and steriods. Go back monday and hope they are back up. Im hoping for a vaginal birth but I want my counts above 100 just in case I need the c section. I hope your little guy turns around. I was told there are ways to manipulate the baby to get them to turn..and also that usually on your 2nd the baby doesnt drop or turn until right before delivery. So you never know he may turn himself around.

Looks like there is a growing number of us dealing with ITP in our last trimester. I am 29 weeks today but my platelets have been in the low thousands (3000) since early February. This is my first time ever even hearing of ITP so to suddenly try to manage this is very stressful I had IVIg 2 weeks ago with good results and am going for weekly blood draws to keep an eye on things. This is my 2nd pregnancy. All we can do is follow doctors orders and keep hope for healthy pregnancies and safe deliveries!!

Thanks for your responses... nice to feel less alone, though I am sorry for you both having ITP.

Tiger - the manipulation technique exists, but according to my Doctors, not a good idea with low platelets. Could even be a danger for the baby - sometimes Mama's antibodies cross the placenta, and kill baby's platelets too - so you wouldn't want him being poked to turn from the outside without a good count to keep him safe.

My C-section was scheduled today - he's still breech. It will be next Thursday, March 24. I have mixed emotions. I am happy to have a date, a plan, a controlled environment in which my platelets should be under control. I am sad that this won't be a natural delivery, that I won't be able to hold him right away, that I will be at the hospital and away from my toddler longer, and then unable to carry him for awhile. Who knows - maybe this little one will turn!

Drifter~I had a c/s for my 1st and am going to need one for this baby too due to a low lying placenta. I understand your concerns about being put under with general anesthesia, I fear this too. Why are they thinking general is safer? Just curious.
As far as c/s recovery goes, every woman is different BUT my last c/s healed wonderful and I have had not issues as a result of it. C/S babies are beautiful

From a pregnancy forum I belong to. I found this 1st hand experience and thought I would share it with you.
This mom is talking about being under with general anesthesia for the delivery of her babies.

"Nobody is allowed to be present with you. Now before you get sad, know that it's really not that big of a deal. I'll explain. My husband had to wait in a hallway right outside of the surgical room. On my babies' birth certificates it states that they were born at 1:07pm. Well pictures on our digital camera state that the first picture of my husband with the twins was taken at 1:09pm. That means that they were in his arms within 2 minutes of being born. That's not that bad. He said he could hear them cry when they came out through the door. In addition, my husband was VERY nervous and anxious about watching the surgery. I know, I know, that he could have been behind a curtain, but if something ever went wrong, neither of us wanted to witness it (our pregnancy and delivery were both very high risk). This really worked out for everybody. Again, he waited just TWO minutes to hold our babies. The babies were born at 1:07pm, I was stitched up and in recovery by 1:45pm, I woke up at 1:50pm and it took about 3-5 minutes to come to. I held my first baby at 2:00pm and the second baby a few minutes later. So, I met them 53 minutes after they were born, but just 10 minutes after I woke up. Now I wanted things this way, but I can understand if you're apprehensive about it. Please, trust me when I say that it is not a bad way to go. I did not have to contend with numbness in my body, no withdrawls, no shaking, no fevers, no site pain (in spine), no spinal headaches...the list goes on and on. Epidurals/spinals can cause a lot of after effects, generals do not. I also never felt "high". A lot of epidural moms talk about a high feeling or disillusion. You will not have that because as soon as the medicine is shut off, it's off. There is no "coming down" period. This means that you will be much more alert and ready to see your baby. There really are a lot of benefits, people just don't like to consider them because they want to SEE their baby born. I regret nothing and my babies and I were healthy as could be and left the hospital together 3 days later. Best of luck to you. Let me know if you have any other questions about procedures or such"

Cloyd - thanks for your posts! I feel a bit better about being put to sleep, if need be... It is not that it's safer - it's because you need a certain level of platelets to have an epidural (75,000-80,000), otherwise you could have bleeding in the spine. So if counts are too low, then general anaestesia it is!

My C-section is BOOKED!! For next Thursday! If by any chance he turns, then I will just be induced. Will keep you both posted.

Keep us posted!! I am excited for your new arrival!!

Drifter, sending good thoughts your way. But I spoke in depth with my neonatologist who assured me that there is a very small percentage of my anitbodies crossing the placenta and effecting the baby. That it is very rare for the baby to have low plaelets. From what I understand its less then 1%. That put me at ease knowing my little boy wouldnt need more then the routine blood plannel they do at birth. Have you seen a neonatoloigst? It may be worth checking just in case.

Tiger - I am followed up by a high-risk unit of Doctors, including pediatric specialists and every other Doctor possible. Yes, the chances are very rare - but my Doctor won't do the inversion on us anyways. I trust his call... Who knows! Maybe he'll turn on his own! Will keep you posted!

Doing a "turn baby turn" dance!!! :silly:

Hi ladies... well, he never did turn! Thanks for the dance though Cloyd... he was a c-section - and everything went perfectly perfect. He turned a year old on Saturday. Time flies... and my baby brain is kicking in again. I think we're gonna go for a third... even re-reading this "stressed out" post - isn't it all worth it in the end when you have that beautiful little muffin in your arms????????? How many do you all have??

Drifter I have 2 boys. Isaac will be 4 in December and was a text book pregnancy. Perfect. Jaxon was my high risk pregnancy (counts went to 3) never had platelet issues before him. At his delivery. Had my tubes tied. 2 healthy boys is lucky enough for me