Causes, Symptoms, & Treatment-
Q 1) Will Thrombocytopenia affect unborn baby?
There are several causes for Thrombocytopenia (Low Platelet Counts) in pregnancy. All have different implications for the mother and the unborn baby. The most common cause of Thrombocytopenia is called Gestational Thrombocytopenia (GT); ‘Gestational’ means due to the pregnancy itself, with no other cause for the platelet count to be low. GT is responsible for more than 70% of thrombocytopenia during pregnancy; is usually mild with platelet counts > 70,000/µL; disappears by one week after delivery and there are no symptoms of abnormal bleeding. The baby, while in womb and after delivery, is not affected by this condition and there are no complications or bleeding problems in the baby.
Q 2) What are the symptoms when a pregnant woman has low platelets?
Symptoms appear depending upon the severity of the problem. Normal range of platelet counts in the non-pregnant patient is 150,000 – 400,000/µL; the mean is 250,000/ µL. During pregnancy this mean value dips a little lower to 215,000/µL, due to certain changes in the body because of pregnancy. Thrombocytopenia can be defined as platelet count less than 150,000/μL in non-pregnant and 116,000/μL in the pregnant patient. Mild thrombocytopenia is 100,000-150,000/μL. Moderate thrombocytopenia is 50,000-100,000/μL. Severe thrombocytopenia is < 50,000/μL. Usually there are no symptoms and it is detected on routine blood tests during pregnancy since automated machines check platelet count once blood sample is tested for haemoglobin and Total Leucocyte Count (TLC). In severe cases there may be bleeding under the skin, bruise patches, or bleeding from nose and gums. Rarely there may be blood in the urine or stools or even in the brain. Bleeding associated with surgery is uncommon unless the platelet counts are lower than 50,000/μL and significant spontaneous bleeding, by itself, is rare unless counts fall below 10,000/μL.
Q 3) Is there any possibility to treat Thrombocytopenia when I am pregnant?
Yes, certainly thrombocytopenia can be treated in pregnancy. Treatment is dependent upon the cause of thrombocytopenia. No treatment is necessary for gestational thrombocytopenia. If thrombocytopenia is due to high blood pressure/convulsions (known as pre-eclampsia/eclampsia) as in 21% cases, the treatment is to deliver the baby after ensuring the baby’s maturity and well being. In 3% cases in a condition known as Immune Thrombocytopenia (ITP), the mother can be given steroids, globulins and Anti-D injection to help increase the platelet count. Removal of the spleen is preferably done before pregnancy to decrease the breakdown and removal of platelets from the circulation. Platelet transfusions may be required when they drop to <10,000/μL or there is bleeding.
Q 4) Will pregnant women have any neurological side effects after the treatment?
Risks of steroid use include high sugar levels in blood, fluid retention, and bone calcium loss. Little data are available on the use of anti-D immunoglobulin in pregnant women; risk-benefit ratios need to be considered prior to its usage. Removal of spleen is usually avoided during pregnancy for technical reasons, although it remains an option in the first six months of pregnancy when ITP is severe (counts < 10,000/μL) and the patient does not respond to steroids or immune globulins. Platelet transfusions are less helpful in ITP. Other than these side-effects and considerations, there are no neurological side-effects of treatment of thrombocytopenia during pregnancy.
Q 5) Are there any natural remedies to treat low platelet count?
Q 6) How to increase (any possible ways) platelet count during pregnancy?
Q 7) Are there any diets which help to increase platelet count?
Answer for all of above questions: There are no scientific studies or data to point at specific diets that may improve the platelet count but the internet is replete with such unproven remedies. These include papaya juice and leaves, pumpkin, carrots, beetroots, kale, spinach, gooseberry, tamarind, raisins, walnuts, peanuts, pistachio, figs, almonds, plums and strawberries. The main idea is to increase Vitamins A, D, C, K. However, it’s a well known fact that unnatural diets cannot give as much benefit as one hopes. Further, one tends to gorge on such diets thus taking in far too much amounts than is recommended. It is suggested that one should consume natural, locally available, seasonal food in medium proportions with an aim to eat all and exclude none. Certain foods, however, are as a result of evolution and civilization and are consequent to change from nomadic ways to agriculture based diets. These ‘imposed’ foods are highly allergenic for humans and include wheat based diets, milk and dairy, non-vegetarian food acquired from industrial animal farms, sugar and salt. If one can eliminate these from one’s diet, the whole human body machine is likely to function in its natural and healthy state. This works to prevent dis-ease but one may need prescribed diets in presence of diseases like diabetes, kidney failure. However, there are no such diets prescribed to improve platelet counts other than a balanced, healthy diet eaten in moderation.