🔴 Low Platelets in Pregnancy

What every pregnant woman should know?

Low platelets during pregnancy is a common finding — but not every low number is dangerous, and not every case needs treatment.

🔍 What are platelets?

Platelets help blood clot and prevent excessive bleeding.

Normal platelet count is usually 150,000–450,000.

🤰 Why do platelets drop during pregnancy?

1️⃣ Gestational Thrombocytopenia (Most common – 70–80%)

✔️ Appears in late pregnancy

✔️ Mild drop (usually >70,000)

✔️ No symptoms

✔️ No treatment needed

✔️ Resolves after delivery

2️⃣ Immune Thrombocytopenia (ITP)

✔️ Platelets may drop below 70,000

✔️ May occur earlier in pregnancy

✔️ Sometimes needs treatment (steroids or IVIG)

3️⃣ Preeclampsia / HELLP syndrome

✔️ Associated with high blood pressure

✔️ Liver enzymes abnormal

✔️ Requires urgent management

🩺 When do we treat low platelets?

👉 Not based on the number alone

Treatment is considered if:

• Platelets <70,000
• Active bleeding
• Rapid drop in count
• Planned surgery or delivery requiring safe levels

💊 Treatment options (according to guidelines)

✔️ Corticosteroids

Used mainly in ITP, not gestational thrombocytopenia.

✔️ IVIG (Intravenous Immunoglobulin)

Used when:

Steroids fail

Rapid platelet rise is needed before delivery

✔️ Platelet transfusion

Reserved for:

Surgery

Active bleeding

Severe thrombocytopenia

🧠 Delivery & anesthesia considerations

Vaginal delivery is safe if platelets ≥ 50,000

Cesarean section usually requires ≥ 50–80,000

Regional anesthesia decisions are made case-by-case

💛 Key message

🔹 Most cases of low platelets in pregnancy are benign

🔹 Proper diagnosis matters more than panic

🔹 Management should always follow evidence-based guidelines

🔹 With close monitoring, outcomes are usually excellent.

Dr Rabab Cares

Because reassurance is sometimes the most important treatment 🌸

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