Monday, April 7, 2014

thrombocytopenia

one topic i've been meaning to discuss with this pregnancy is that i'm high risk due to an autoimmune disorder called idiopathic thrombocytopenia purpura / immune thrombocytopenia, or ITP. or in laymen's terms, "low platelets." platelets are made in your bone marrow and help your blood to clot. because i have low platelets, i don't clot as easily.

i found out that i had ITP during routine bloodwork with my miscarriage pregnancy. we had additional testing done and discovered that i tested positive abnormal for three types of platelet antibodies. essentially, my immune system attacks and destroys its own platelets.

the diagnosis made a ton of sense after we figured it out. i get bruises very easily and sometimes the bruises are huge. i can recall our dog stepping on my thigh a few months ago, then two days later i had a bruise the size of a softball. i also have tiny red/purple dots all over my chest and top of arms that i used to think were acne but could never be fixed with medicine from the dermatologist. i don't get nosebleeds terribly often, but i often bleed simply from blowing my nose. no matter how much i floss, the dentist always says that my gums are bleeding too much during routine exams. it turns out that all of these things are symptoms of ITP.

it's not a life-threatening illness, but there are a few things i have to be cautious about. for instance, if i ever got into a terrible car wreck or something, i could bleed out quickly because my blood won't clot correctly. the other big ones relate to pregnancy.

it was important to test for platelet antibodies before because they can cross the placenta and affect the baby's platelet count. since i tested positive, alex will have to be monitored closely at birth to make sure his platelet count is not affected. or if it is, that he gets the appropriate treatment.

if my platelet count is low in the weeks before delivery, i'm at higher risk for heavy bleeding during labor. i will see the perinatologist (specialist) every month until the end, when i believe i'll start to visit every week to monitor my platelet count. there are things you can do to raise the platelet count temporarily, like take steroids or have a platelet transfusion. i think some people have to have emergency c-sections or induce labor earlier if the remediation measures don't work.

the other risk is related to epidurals. if my platelets are too low, i can't get an epidural.

insert freak out here.

i feel like i had the easiest labor and delivery in all of labor and delivery, and part of that is because i was induced and had an epidural. i need history to repeat itself! i don't think i can do pain!

anyway, those are my high risk pregnancy woes. i haven't been too worried because my test results have been pretty good and i haven't needed to worry. maybe i'll be a mess toward the end, but for now everything is going smoothly. hopefully it stays that way so alex is healthy and i can have my epidural! :-)

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