Planning your pregnancy with ITP
Fact-checked by When you are living with immune thrombocytopenia (ITP), pregnancy can be a time of excitement but also of worry. You may have general questions about ITP and pregnancy, as well as delivery and postpartum planning.
Having access to the right information can help you learn more about planning pregnancy with ITP so you can feel better supported and confident about your family’s future.
How ITP affects having children
It is generally safe for women with ITP to get pregnant and deliver a child. However, careful monitoring is required during pregnancy due to certain features of the condition.
In ITP, the immune system mistakenly attacks platelets, the circulating cell fragments needed to help blood clot after an injury. This leads to low platelet levels, called thrombocytopenia, which, in turn, increases the risk of bruising and bleeding.
Pregnancy can further affect platelet levels. A slight drop in platelet counts is normal in any pregnancy due to an increase in blood volume and cell recycling. However, this tends to be more common and severe if you have ITP.
Most pregnant women with ITP will see their platelet count decrease during pregnancy, and about half require treatment due to a significant drop in platelet levels.
ITP-related thrombocytopenia usually occurs in the third trimester, while the type of thrombocytopenia seen in healthy pregnancies normally occurs early in the pregnancy.
Because thrombocytopenia in pregnancy can increase bleeding risk during delivery, careful monitoring can help protect your and your baby’s health. If your counts dip, your doctors will need to distinguish between your preexisting ITP and standard gestational thrombocytopenia to ensure you receive the right treatment.
Preconception checklist
Planning pregnancy before conception can help your doctor anticipate any potential issues and address them.
Some recommendations include:
- Schedule an appointment with your ITP doctor to discuss any potential concerns and ask any questions you may have.
- Make a plan together for managing your condition during pregnancy.
- Ask your doctor whether adjustments to your ITP treatment plan may be needed.
- Try to eat well and manage stress to support your overall health and prepare your body for pregnancy.
You may also want to start thinking about building a multidisciplinary care team for pregnancy, delivery, and postpartum. Its members may include:
- a hematologist who specializes in ITP and other platelet disorders
- an obstetrician or high-risk obstetrics specialist
- an anesthesiologist
- a pediatrician or neonatologist
Treatment planning during pregnancy
Some of the key aspects of ITP treatment during pregnancy are consistent monitoring and open, honest communication with your care team.
The main focus during pregnancy with ITP tends to be on maintaining a platelet count that is high enough to prevent significant bleeding. During pregnancy, expect to:
- undergo frequent blood tests to track blood platelet count
- attend regular prenatal visits
- be prescribed medications to increase platelet count if needed
Keep in mind that platelet count drops are common in ITP pregnancy and may not always require treatment. Your care team can determine whether treatment is needed to address low platelet counts during pregnancy.
The experience of pregnancy with ITP varies from person to person, so it’s important to communicate with your care team if any issues arise. If you notice any concerning changes, be sure to report them to your care team so that they can work to find a solution.
Delivery planning
Your care team can help you plan your delivery. While vaginal delivery with the condition is generally safe, your doctors will determine whether this method of giving birth or a cesarean will be best for you based on a range of obstetric considerations.
In addition, your care team will focus on maintaining a platelet count that supports a safe delivery. They will also collaborate on selecting the best pain management options, such as an epidural, as well as ensuring adequate platelet counts to enable these options.
Things to look out for after birth
Careful monitoring of platelet counts and bleeding risk should continue after delivery. You should also notify your care team as soon as you notice any concerning symptoms.
Things to watch out for:
- significant vaginal bleeding
- large or worsening bruises
- signs of delayed postpartum bleeding
A few babies born to mothers with ITP will have low platelets at birth. This is usually temporary and treatable, but the pediatric team will want to check the baby’s blood count immediately after delivery. If it’s below a certain level, the baby will be monitored and treated.
Postpartum and breastfeeding planning
After you give birth, your care team may make specific recommendations regarding postpartum care and other aspects of your and your baby’s health.
Postpartum care includes:
- monitoring platelet counts and postpartum bleeding risk
- adjusting treatment as needed
- watching for symptom changes or flares
- potential additional newborn platelet monitoring
Breastfeeding with ITP is generally safe, though you should consult your care team for their specific recommendations.
Although planning a pregnancy with a chronic condition can be stressful, there are ways to prepare and manage potential risks. Working with your healthcare team can help you feel confident and supported throughout the process.
Bleeding Disorders News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
