Low platelet count?

[Baby_Cakes]

I'm 21 weeks pg and my blood work showed a low platelet count of 138.  I'm planning a homebirth and my midwife said that they don't like to keep you home with a count lower than 140, b/c of risk of bleeding.  She suggested Yellow Dock tincture, but can anyone offer any other ideas to help me get this count up?  I don't want to get risked out of homebirth for this!  

TIA!

[mt_gooseberry]

You have a platelet count of 138,000?  I wouldn't worry...mine is only 40,000!  You're hardly below normal.  It sounds like you have gestational thrombocytopenia.  Like gestational diabetes, it comes on during pregnancy and goes away after you give birth.  Obviously it makes it harder to stop any bleeding, but the real trouble doesn't start until you're at about 50,000.  In fact, they don't even recommend treatment until you're at 50,000...anything above that, and they just like to monitor things.  Especially if you're asymptomatic (no bleeding gums, purpura [blood blisters], easy bruising, etc) there shouldn't be any reason to change your birth plan, imho.  Granted, I'm not a doctor, but as someone who has this condition ALL the time, not just during pregnancy, I kind of feel like I know what I'm talking about.  In fact, they recommend as natural a birth as possible, because C-sections are not recommended (when you cut open the body, there's going to be bleeding) and they usually refuse epidurals to those with thrombocytopenia. Here's a good medical journal article you might want to take a look at:

http://emedicine.medscape.com/article/272867-overview
 

[Baby_Cakes]

Thanks!!! 

No, no signs of anything, my midwife just said she didn't feel comfortable b/c of possibility of bleeding after the birth.  Freaked me out a bit!  And I read up a bit on what can raise platelet count, and it seems my diet of mostly refined, processed foods could be the culprit.  Can't hurt to change that, huh?  

Thanks so much for your reply, I appreciate it, especially since you battle with this condition normally.  

[mt_gooseberry]

You also might want to keep a closer eye on your blood pressure, b/c there can be an increased risk of preeclampsia with GT.  I actually haven't told my midwife about my platelet count yet, b/c I'm worried she might make me have a hospital birth too (instead of in the tub at her birth center), so I know how you feel....  I know I need to tell her, but I don't have any symptoms right now and I'm desperate to avoid another delivery like my last one. 

[Baby_Cakes]

Thanks, I will keep an eye!  Do you do anything specific in your diet to raise your platelets?  Good luck with your midwife. I hope this condition doesn't risk you out of the birth you envision.  

[Nanette56]

138 is a good number. They're probably just super cautious because of the possibility of hemorrhage. My platelets went from 124 to 122 to 119 to 107 and then to 101. Before my section (both babies were breech) the doc told me I needed to have a count of over 100 in order to be able to have spinal anesthesia and not general (in case a transfusion was needed). They weren't terribly worried, but it FREAKED me out!! I did NOT want general anesthesia! So the two days before the section I ate Spinach, Spinach and more Spinach (Spinach salad after spinach salad seriously) and also pigged out on blackberries. The day of the section they tested my blood one last time and it was at 118! I swear it was the Spinach. I just googled online, and asked my doula, and it was her suggestion. She also said something about shark oil, but since it hasn't been thoroughly tested I was a little leery of it, but you might want to look it up. I wouldn't worry too much though mama, don't let them freak ya out about it. And try the spinach! ;)

[Kokopelli-mana]

Oh no! I hope things work out for you,,, The number is so close to the limit.
Was that test "required"? I 'm wondering because I don't want to get a test that will prevent me from homebirth.
I'm sure you'll get the number up - it's so close!!!

[Baby_Cakes]

Thanks guys!  I'm trying not to freak.  And I have plenty of time to really work on this so at least I have that on my side.  I will be adding tons of spinach to my diet!! Ha!

Kokopelli - It was part of the complete blood panel that my midwife did with the initial bloodwork, so I would guess it is something they routinely screen for, like red or white blood cell count. 

[MamaKickyPants]

Mine was 129 a few weeks ago so they re-tested and it was back up to 150. even 129 is not that low, is my understanding. My MW recommended nettle tea - you could try that. Their threshold for 'normal' was 130. I hope it works out for you mama - true GT is pretty rare. It's probably just a normal fluctuation. I'd be inclined to get re-tested, esp if they are considering ruling out a HB with the current numbers. What have you got to lose with a re-test?

[Baby_Cakes]

I'm definitely getting retested.

Another thing my DH brought up was how the blood was taken.  I know nothing about taking blood, but my mw apprentice did the draw.  I remember the blood not flowing fast, stopping in the tubing, and it took about 15-20 seconds to start flowing.  It stopped/started quite a few times while she was taking it. DH read that if the blood isn't collected fast enough, it can definitely throw off the platelet count if it starts to clot before hitting the anticoagulant (?).  So, we shall see, for sure.

And I bet if it was a hospital birth, it wouldn't even be an issue.  I know homebirth midwives just really like to cover their butts with things like this.  Makes sense to me. 

[mt_gooseberry]

You're right about clotting in the vial and getting a false positive.  I actually got retested yesterday because more than once they've drawn my blood and it has clotted in the vial, so I've been wondering if my low count is because of this.  Even if it does turn out that I really do have such low platelet numbers, my current healthcare provider feels that I should still be able to go through with an alternative birth, so if I can do it at 40,000, you should really insist on being able to follow through with yours!