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I've never had an issue specifically with my platelets but while not pregnant I had repeated readings of low lymphocytes and neutrophils during a routine blood test administered by my internist. I was referred to a hematologist and they re-ran the results and found that it was lab error. Apparently, some labs use machines to do blood counts and it was causing errors. The lab used by the hematologist had a lab tech that hand counted under a microscope. My internist told me years later that I was the sole reason that the entire huge practice voted to switch labs. Anyway, my point is that you might ask about how the lab counts your platelets just to confirm that this isn't lab error and you may also consider getting a referral to a hematologist if the problem remains when you get re-tested.

@periwinklebee: The lab may have capabilities to do both or may be able to send it elsewhere. I would think that a hematologist would have better resources than an OB office. Good luck! Hope it was just an error or something that corrects itself quickly.

My sister in law had very low platelets for both her pregnancies. She was monitored very closely. She had 2 c-sections. Her first was breech and she opted for another c-section for #2. Both my nephews were healthy.

I had low platelets for both my pregnancies. I was monitored by a hematologist monthly. I don't remember him saying that I couldn't have an epidural, but it has been been over 5 years ago since my last pregnancy. They did say that if they went too low I would have to be put under for my 2nd c-section, which didn't happen. The first pregnancy I had an epidural and then a c-section. I had to see the hematologist for a couple months after birth until the numbers raised back up into normal range.

I also had gestational thrombocytopenia. Mine was diagnosed early (around 16 weeks I think) but was only 130k then. Mine runs low even outside of pregnancy. I was monitored with monthly blood tests that then became every 2 weeks. I saw a hematologist that said that there is a dilution effect of pregnancy because you have more blood while pregnant so that's something to consider.

Mine then stayed around that range until 36 weeks when it dropped to 92k. At that point my OB consulted with MFM and I did a week of the steroid prednisone. It raised it back to 120k or so. I then went off it for a week but my platelets dropped again. We decided at that point to induce at 39 weeks.

The night before my scheduled induction I went in to get checked because I had some blood and fluid so I thought my water had broken. It hadnt but they checked my platelets and they were 78k so I was admited at 1 am. I'll spare you all the details (wall me if you want them) but I delivered vaginally after an epidural at 10:30 am. It was a near thing. I got the epidural at 9am and my platelets were 57k. The cutoff depends on your hospital but I wouldn't have been able to get an epidural lower than 50k. Otherwise yes, I would have had to have a C section under general anesthesia. I did ask for the epidural around 8:15 (water broke on its own at 7) but they had to redo the bloodwork and it just took a bit. I wasn't even really hurting when I asked for the epidural but my contractions got fast really quick.

I lost a lot of blood. I didn't have to have a transfusion but I wish I had. Recovery was hard due to low iron and low platelets. I have never felt so tired. But I had a very healthy 8lb 1 oz daughter and I'd do it again in a heartbeat. The worst part was actually that I had a (unrelated) third degree tear.

Let me know if you have any questions and I'm happy to answer them. It's such a weird thing!

@periwinklebee: it was definitely scary to find out miidway through delivery, but it's great to know beforehand. I wouldn't be super worried about it because there's definitely treatments.

I WOULD, however, definitely sign up for some natural birthing classes or do some reading if possible, if you have to go that route. Push for a postpartum blood transfusion if possible... obviously the hospital & OB have guidelines when that is necessary, but if you're borderline or feeling like absolute crap, I would definitely bring it up. Lastly I would start taking iron with vitamin C either now or definitely postpartum ( the vitamin C helps your body absorb it, do not take your iron with your prenatal, they'll just interfere with each other.)

I have immune thrombocytopenia (ITP), which is low platelets in general. My normal is around 70k. During my first pregnancy, they dropped to around 30k before they were caught (I wasn't being monitored as closely as I should've been) and put on prednisone (a steroid) around 37 weeks. By the time I went into labor, my platelets were back up to 50k. It meant I couldn't have an epidural, but otherwise didn't affect me. After birth, my platelets rebounded back to normal and I weaned off the prednisone.

For my second pregnancy, I made sure that I saw my hematologist monthly and got my platelets checked monthly. When they started to dip, I went on prednisone (around 32 weeks). Again my platelets were around 50-60k when I went into labor, so no epidural, but otherwise I was fine.

I had two vaginal deliveries, including an episiotomy without excessive bleeding or any issues.

My hematologist said they like your platelets to be above 100k for an epidural and above 50k for a c-section. If yours get too low, they'll put you on a steroid to help increase them. They can also give you a platelet infusion if necessary, but I doubt it will come to that.

Good luck!

@bees_knees: yes, I was low in everything and slightly high in white blood cells (leukocytes???) So they were worried about infection too. So yes, the purpose was not just platelets.... but I was given the impression that it would help overall, since there are also platelets within the whole blood. I wonder how many platelets are in one blood transfusion typically?

@bees_knees: ah, very interesting! thanks for the info!

I had low platelets with both pregnancies. First one they were borderline low at 28 weeks and at 90 when I arrived for my induction on my due date. I was ineligible for an epidural because my hospital's cutoff was 100, and I delivered unmedicated.

Second I was again borderline low at 28 weeks and was retested a few times but they never dropped below the 120s. Delivered unmedicated at 39 weeks.

Only difference that may have had an impact was I took a prenatal with iron in second/third tri with my second, and I don't think my prenatal had iron in my first.

Otherwise I recall my midwives said 50 was the threshold for needing more monitoring or treatment, not sure which of those.

Good luck and I hope everything turns out ok! For me it was not a big deal either time but I'd suggest being prepared that an epidural could be off the table.