Platelets are plate-shaped cells present in the blood, responsible for blood clotting. The normal level of platelets is between 150 million and 400 million per milliliter of blood. If the level of platelets in your blood is less than 150 million, the condition is called thrombocytopenia. Low platelet count is a rare condition to occur during pregnancy, where only around 5–8% of pregnant women experience it. Mentioned below are the causes and complications associated with thrombocytopenia during pregnancy.
Causes Of Low Platelet Count During Pregnancy
1. Gestational Thrombocytopenia
The incidence of low platelet count during pregnancy is called gestational thrombocytopenia. It usually occurs during the third trimester. Experts are unsure about the exact reason that causes it, but say that the following two factors could play a role:
- Your body has the innate ability to kill platelets when they are not used and replace them with new ones. During pregnancy, this process speeds up leading to the presence of young platelets and not the completely mature ones.
- Your body produces 50% more plasma (the fluid part of the blood) during pregnancy. This results in dilution of platelets, thereby reducing the number of platelets per ml of blood. These, however, are equipped enough to function well.
2. Immune Thrombocytopenia
Immune thrombocytopenia is an autoimmune disorder where the immune system treats platelets as foreign bodies and attacks them. This condition can exist even before pregnancy and can come to light only when you are tested for platelet count during the first trimester. It could have usually developed after a severe viral infection during the childhood.
Preeclampsia is one of the serious conditions occurring during pregnancy in around 5–8% of women. It is characterized by high blood pressure and the presence of protein in the urine. Low platelet count could be an indication of impending preeclampsia or a more severe condition called HELLP syndrome. Both conditions could pose a risk to both the mother and the baby. An immediate medical attention would be required if these conditions are diagnosed.
4. Drug Interactions
A few of the drugs can affect the platelet formation or function during pregnancy. Some of them are antifungal agents, blood-thinning agents like heparin, and certain painkillers. It is highly advisable not to take any medications without consulting your doctor, especially during pregnancy.
AIDS can break down the immune system to a great extent where the body stops fighting against diseases. In some cases, AIDS might affect the bone marrow of the body, which is the organ producing blood cells, including platelets. Improper functioning of bone marrow could lead to immature or malfunctioning platelets.
In any of the above cases, once your platelet counts are tagged as low, your doctor would periodically monitor the levels. During the third trimester, some women might require a platelet transfusion as well.
Complications Due To Low Platelet Counts
1. Increased Bleeding During C-section
Generally, there is more blood loss during a C-section than a normal vaginal delivery. Since uterus has an increased supply of blood during pregnancy and childbirth, the blood vessels are usually larger. When cut open, healthier women can tolerate the blood loss. But if the platelet counts are low, the blood loss might manifold, requiring a transfusion.
2. Risk Of An Epidural Going Wrong
In a case when an epidural is required, the anesthetist will take extra precautions to place the needle at the right place. This is because an accidental puncture in the epidural space could lead to the collection of blood in one place, resulting in permanent paralysis and spinal injury.
Most health-care providers consider thrombocytopenia as a risk factor which could cause further complications. And therefore, monitor you closely even after childbirth. It is important to know that any platelet-related disorder that occurs during pregnancy can be reverted. You and the baby (if effected) will eventually have normal platelet counts with passing time.