The number of platelets in the blood of the expectant mother is of great importance for pregnancy and childbirth. These blood cells are involved in blood clotting, preventing large blood loss, and also help wounds heal faster. Not having enough of these platelets can be dangerous for the mother and baby. In this article, we will tell you what to do if your blood test shows low platelets.
How the level is determined
Establishing the level of platelets in the blood allows a general analysis, which does not require any preliminary preparation from a woman. A general clinical blood test is done several times during the period of bearing the baby. Doctors have the ability to track changes in blood composition over time.
For women who are not pregnant and for men values of 180-360 * 10 ^ 9 cells per liter of platelets are considered normal. While carrying a baby, the norms are somewhat different. The platelet count in a pregnant woman is reduced compared to non-pregnant adults, and there is a reasonable explanation for this.
By the middle of pregnancy, the amount of blood in the body of the expectant mother increases, and in this regard, the concentration of individual cells, in particular platelets, decreases.
The number of platelets from 140 to 340 thousand / μl with aggregation from 40 to 60% is considered normal for a woman carrying a baby. The number of platelets in the blood decreases gradually, the lowest value occurs in the third trimester. But nature has disposed wisely - while reducing the number of cells that are involved in coagulation, it increased their ability to aggregate. This is a kind of preparation for an important event - childbirth, because they are always accompanied by bleeding to one degree or another.
Norms of platelets in the blood of pregnant women - table of average values:
A decrease in platelets in excess of the norm is called thrombocytopenia. It is always associated either with insufficient production of platelets, or with a decrease in their ability to aggregate and participate in the most important biochemical processes in the body.
Reasons for the decline
The reasons why the number of platelets in the blood decreases are manifold. In order for the doctor to understand what exactly led to such a clinical picture, additional research will definitely be needed. For this, a woman is prescribed donation of blood for biochemistry, as well as for infections, including hepatitis and HIV status.
To understand whether everything is in order with the function of these platelets, they will prescribe a comprehensive blood clotting test, which will show not only the number of platelets, but also their quality, determine the rate of blood clotting, and show whether there are enough enzymes and proteins involved in factors coagulability.
The following diseases and conditions most often lead to thrombocytopenia:
- Allergy. With any inadequate reaction of the body to an allergen, the composition of the blood changes. The platelet count may be reduced.
- Autoimmune processes. Quite often, the reason lies in the fact that a woman's body produces special antibodies that destroy platelets. A decrease in this case is inevitable.
- Inadequate nutrition and lack of vitamins. An unbalanced, poor or unhealthy diet affects the blood composition, while quantitative formulas can fluctuate noticeably in one direction or another. Most often, low platelets during pregnancy are observed with a deficiency of vitamin B 12 and folic acid.
- HIV infection. In a state of immunodeficiency, the number of platelets decreases sharply. Even if the first test for HIV was negative (and it is done to all pregnant women upon registration), there is no guarantee that the second test will also be negative. The incubation period of the disease is long, and the infection could occur after registration.
- Thyroid problems. If this gland produces insufficient or excessive amounts of hormones, this also cannot but affect the composition of the blood.
- Diseases of the blood. Some ailments, such as leukemia, are accompanied by a significant decrease in the number of platelets, platelets. A woman will need a consultation with a hematologist and an additional examination in order for this reason to be confirmed or refuted.
- Oncology. Recently, the number of pregnant women in whom malignant tumors are found for the first time in the process of carrying a child has increased. In any oncological process, the number of platelets falls. The decrease is more pronounced and rapidly observed in malignant processes affecting the bone marrow.
- Exacerbation of chronic diseases and acute ailments. Infectious diseases, as well as the existing pathologies of internal organs during the carrying of a child, are also undesirable because they affect the composition of the mother's blood, lead to thrombocytopenia, anisocytosis (proliferation) of platelets.
- Medicines. Taking certain medications, such as antihistamines, antibiotics, pain relievers, can cause a decrease in the concentration of platelets in the blood of the expectant mother.
Symptoms
A decrease in platelets makes the blood "thinner". This is how thrombocytopenia is popularly designated. This condition has characteristic symptoms and signs that are difficult to ignore. So, a woman with a lack of platelets has bruises on her body quite spontaneously. For this, a forceful effect is absolutely not necessary, sometimes a light touch on the hand of the expectant mother is enough, so that a large and deep bruise flaunts on it in a couple of hours.
A bleeding disorder is manifested not only spontaneous hematomas, but also difficulties in wounds and burns.
Even a shallow wound can bleed for a long time; it can be difficult to stop the blood.
A woman whose platelets have "dropped" is characterized by bleeding gums... This becomes especially noticeable when brushing your teeth. The expectant mother may often experience nosebleeds.
Often, thrombocytopenia during pregnancy is manifested by the appearance bloody pink discharge from the genitals. The mucous membranes, including the vagina, are exposed to the hormone progesterone and other pregnancy hormones, and they become looser. A decrease in platelets and a violation of blood clotting make the membranes even more vulnerable.
Danger
Usually, even a pronounced platelet deficiency is not perceived by a woman as a serious illness that requires immediate medical attention. Her condition is generally not a cause for concern., and this is the main danger of thrombocytopenia. An unsuspecting mother-to-be can develop severe internal bleeding at any time, any wounds and injuries are fatal for her due to the likelihood of losing too much blood.
Childbirth is the most dangerous. Blood loss with them is inevitable, the largest amount is lost at the time of the birth of the placenta.
In a woman with normal coagulability, the surface of the uterine wall, from which the "child's seat" departs, quickly thromboses. If there are not enough platelets, this threatens with massive bleeding, which will be very difficult to cope with even for a team of doctors who are ready for anything.
During childbearing, the mother's "liquid" blood does not give the baby any special problems. It does not interfere with its development, does not interfere with normal growth and blood circulation in the mother-placenta-fetus system. but even a minor placental abruption can lead to the death of the baby and is a danger to the life of his mother... In addition, a woman with thrombocytopenia has risks of dangerous hemorrhages - into the lungs, into the brain, with all the ensuing negative consequences, up to and including death.
Treatment
The first thing to do if low platelets are found is to consult with your doctor and undergo additional examinations. The tactics and treatment regimen depend on the true cause of the phenomenon. Traditionally used for thrombocytopenia prednisoneHowever, this steroid hormone has many side effects, and during pregnancy, treatment differs markedly from standard therapy.
If the reason why platelets were reduced lies in an infectious disease, it should be treated. If we are talking about ARVI or influenza virus, then the blood composition returns to normal after the woman finally recovers, without therapy at all.
Treatment will not be needed even if the number of platelets has decreased due to the medications that the expectant mother took. It is enough just to stop taking these drugs, and the blood composition will return to normal.
If the condition of platelet deficiency is associated with disorders of the thyroid gland, kidneys, then the woman is referred for consultation to a nephrologist or endocrinologist. Together with the gynecologist, these specialists will have to plan a treatment regimen for the underlying ailment.
Special drugs with the ability to increase blood clotting are rarely prescribed, since they are, in principle, not intended for use during pregnancy. If the decrease in platelets is critical, then the woman is hospitalized and coagulants are administered to her in the hospital under the supervision of a doctor. This is especially true when there are only a few days left before childbirth.
Both at home and in the hospital a woman is recommended to take vitamin complexes. She should also be more careful about her diet. Foods that increase blood clotting are bananas, apples, chicken and quail eggs, meat and fish, fresh herbs.
With a slight lack of platelets, changes in dietary rules are more than enough to correct the blood composition.
The most difficult treatment for women with autoimmune thrombocytopenia... They are prescribed hormonal drugs (glucocorticosteroids) in a hospital. In some cases, if the condition of the pregnant woman is threatening, donor blood transfusions can be performed. This helps to at least temporarily increase the number of platelets and increase the body's defenses.
When treating with hormones, most often they start with "Dexamethasone", gradually moving from therapeutic doses to prophylactic ones, until the number of platelets returns to normal or approaches the existing norm.
If hormone therapy cannot raise the number of platelets, injections of human immunoglobulin are prescribed. The expectant mother is waiting for several injections for pregnancy, in each course - only 1 injection.
In the most severe cases, when proper nutrition and hormones are powerless, a woman can, for health reasons, undergo a laparoscopic operation to remove the spleen, because it is in this organ that most of the platelets die. The puncture is made small, the splenectomy itself is performed under general anesthesia.
The dosage of drugs for medication sleep is calculated by an experienced anesthesiologist. The prognosis for such an operation during pregnancy is positive.
For information on how to increase platelets at home, see the next video.
