Hematologist

Tuesday was a double-doctor day.

In the morning, I visited the hematologist. The visit went much as expected. After reviewing my medical history (no liver problems, no low platelet issues outside pregnancy, no medicines possibly affecting platelet levels, etc), he concluded that, yes, most likely I have a case of gestational thrombocytopenia (literally, low platelet levels in pregnancy). There's no way to know definitively that it IS that diagnosis unless my platelet levels don't recover after delivery. But with no other obvious or likely diagnosis, they will operate on that assumption.

The one thing I did learn is that gestational thrombocytopenia is considered to be an auto-immune disorder/disease/whatever term. With the hormonal and other changes in pregnancy, the immune system attacks the platelets, causing the platelet levels to drop. The disappointing (but not unexpected) conclusion being that once a person has this show up in a pregnancy, one is very likely to have it in successive pregnancies.

The hematologist did say that studies confirm that clotting issues don't become problematic until after the platelet levels fall well below 50,000. So even a platelet count of less than 100,000 does not require treatment, except for ob reassurance or hospital policy. If a treatment is tried during pregnancy, the only thing considered safe is a round of steroids. If it works, the steroids suppress the immune system enough to slow the attack on the platelets and allow the platelet count to rise. If it works, the platelet levels jump up quickly. Interestingly, it is the same type of steroid that is used to accelerate lung maturation in the fetus when pre-mature birth is expected.

The hematologist provided me with an order for a blood test on 12/14. The results from that test will be close enough to anticipated delivery, that can be more comfortable about whether my levels are going to still be above 100,000 or not. He requested that I have the test done at one of the local hospitals (rather than a doctor's office), so the test is run immediately and natural clotting will have less impact on the results.