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[quote=Anonymous][quote=Anonymous]I think you need to get the platelet count to make a better decision. I've had 3 children and issues with my platelets for all three so I've become a bit of an expert. The diagnosis I have is pregnancy induced thrombocytopenia and here's how my labor and deliveries went:

- 1st baby @ age 32 - platelets dropped to 35 and I was not given an epidural. The options were C-section or vaginal delivery only. I chose un-mediated vaginal and had no problems but the full medical team was standing by in case I had bleeding issues; no complications with either me or the baby; treatment protocol prior to delivery was steroids starting at week 36; delivered at 40 weeks +2 days

- 2nd baby @ age 33 - platelets dropped to around 80 and I was approved for the epidural but baby came before the anesthesiologist could make it to my floor so I had an un-medicated vaginal; no complications with baby or I; i don't remember the treatment protocol but i don't think we did steroids this time; delivered at 38 weeks

- 3rd baby @ age 39 - platelets dropped to 90 and I was able to get an epidural so I had a medicated vaginal delivery; no complications for ether of us; the treatment protocol was baby aspirin starting (I think) at 12 weeks and up until week 38 - I didn't have to do steroids this go around; delivered at 39 weeks

All of these births were at a military hospital and for each I was treated as a high risk pregnancy with weekly platelet checks starting at 34 weeks. They never pushed me to have a c-section but always told me that if I did - it would be under complete, general anesthesia because the risk for bleeding would be so high. I was not induced for any of my deliveries either - the babies just came when they were ready

I'm age 40 now and pregnant with my last, I'm currently 34 weeks and my platelets are at 78 so we are discussing the protocol now. I have been on baby aspirin since 12 weeks the doctor mentioned some new fusion they could do instead of steroids - i'll try to remember to update this thread after my appoint next week with the details. I also take iron supplements throughout my pregnancies but I have always been slightly anemic.

From my perspective, the things you need to question are:
1. what are you platelet counts?
2. what are the c-section options available to you?
3. what kind of treatment can they offer before delivery to help stabilize your platelet? steroids or something else?
4. What kind of treatment can they offer before delivery to help the baby's lungs develop faster?
5. how will they monitor you after delivery?
6. what are the implications for future pregnancies?[/quote]

This is OP. Thanks- this is really helpful! So my count as of yesterday was 128. It was 135 on August 3 so it is dropping, but not precipitously. My OB scheduled me for an induction on my due date, which is next Saturday. I go back to the OB on Wednesday for another check up, at which point I'll get another platelet test and they'll check my cervix (as of yesterday, no dilation, some effacement, and baby is low). They have told me that at my hospital, anesthesiologists will not do an epidural if platelets are 100 or lower, though this could vary down to 90 depending on the doctor. The c-section option, if it becomes necessary, would be general anesthesia if my count does drop to that point by the time I'm in labor and a c becomes necessary. They have not mentioned any treatment to stabilize my platelets before delivery- I asked and was told there isn't anything you can do for this. With respect to the fourth question, I don't think the baby's lung development is an issue.

The question is whether my count will sharply drop off between now and next week and if not, whether I can push the induction to sometime between week 40 and 41 to give my body more time to go into labor spontaneously. Did your counts drop precipitously? I'm wondering if my count is still in the 120s on Wednesday/Thursday whether  I can safely push induction to middle or end of the week of 8/31. They recommend not going past week 41 because of my age so the latest I'd be induced if it doesn't happen naturally would be September 5. My biggest concern is the risk of needing an emergency c and having to go under. It's impossible to control for how likely it is I'll need a c, but that is the main thing I am trying to avoid. Not having the option to have an epidural during labor would suck but it's the unknown c section scenario I'm most concerned with avoiding.  [/quote]

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