Von Willebrand Disease: Types, Causes, and Symptoms
Understanding Pregnancy-Induced Thrombocytopenia
Pregnancy-induced thrombocytopenia is a blood condition that occurs during pregnancy and reduces the amount of oxygen your blood can carry. It's due to increased fluid from pregnancy.
Thrombocytopenia is a condition that can happen to anyone. People with thrombocytopenia have a low platelet count, which can keep your blood from clotting and increase your chance of dangerous bleeding.
Mild thrombocytopenia happens in about 12% of pregnancies and is the primary cause of low platelet counts during pregnancy. It's unclear how often thrombocytopenia in pregnancy is actually pregnancy-induced.
This article will look at pregnancy-induced thrombocytopenia, how doctors treat it, and whether it can affect the health of the fetus.
Learn more about thrombocytopenia.
Pregnancy-induced thrombocytopenia is a blood condition. In any form of thrombocytopenia, platelets (thrombocytes), a type of blood cell, are reduced.
In thrombocytopenia, platelet counts drop to 150,000 per microliter (μL) or under. The typical range is 150,000–450,000 per μL. The threshold for diagnosing pregnancy-induced thrombocytopenia is a bit lower, at 116,000 per μL or under.
Other forms of thrombocytopenia can affect you during pregnancy, but pregnancy-induced thrombocytopenia is actually due to the way being pregnant has affected your body.
Although different types of thrombocytopenia may have symptoms, pregnancy-induced thrombocytopenia doesn't have any prominent symptoms.
Some people may experience mild symptoms often considered typical symptoms during pregnancy, such as:
It's not a significant cause of maternal bleeding, and often, doctors only diagnose it through routine lab testing.
The primary cause of thrombocytopenia during pregnancy is the effects of all the extra volume the body is carrying to support a fetus.
Plasma, the main liquid element in your body, increases by 6% at the start of pregnancy and peaks at around 50% just before delivery. This increase in the fluid inside your body may dilute your blood cell counts and other nutrients.
Generally, experts think of this condition as a physiologic response to pregnancy rather than a disorder. However, people who have had thrombocytopenia in previous pregnancies or who have had multiple pregnancies overall have a higher chance of this condition. It typically occurs late in pregnancy and resolves after delivery.
Other causes of thrombocytopenia during pregnancy that may cause your platelet count to drop significantly and require more intensive treatment include:
If you have thrombocytopenia during your pregnancy, your doctor will determine if another condition that may need treatment has caused it.
Pregnancy-induced thrombocytopenia generally doesn't require any particular treatment. A doctor may monitor you throughout your pregnancy for additional drops in your platelet count, but the condition usually resolves on its own within a month or two of delivery.
Generally, the health of people who develop pregnancy-induced thrombocytopenia is good, even with a low platelet count. The same is true for developing fetuses and newborn infants.
According to one paper, no babies born to those with pregnancy-induced thrombocytopenia had any form of thrombocytopenia themselves at birth.
Pregnant individuals and their babies have a good outlook after pregnancy-induced thrombocytopenia.
For the birthing parent, platelet counts tend to return to typical ranges 4–8 weeks after delivery. Infants born to people with this condition don't seem to carry any ongoing effects, either.
How do you treat valproate-induced thrombocytopenia?Valproic acid is a medication that controls seizures and treats mood disorders, but thrombocytopenia is a possible and serious side effect of the medication.
If you develop thrombocytopenia while taking valproic acid, talk with your healthcare professional. They'll guide you through the process of stopping the medication and transitioning to an alternative medication.
In some cases, you may need a platelet transfusion to help you overcome this medication effect.
What's the life expectancy of a person with immune thrombocytopenia (ITP)?People with ITP acquire the condition after an immune reaction triggers an attack on their body's platelets.
Mortality rates for adults with this condition are 0–7% due to complications like major bleeding, bleeding in the central nervous system, and cancer from infections related to immunotherapy.
Can pregnancy cause thrombocythemia?Thrombocythemia is the opposite of thrombocytopenia. It causes your body to produce too many platelets. The chance of blood clots is increased in general during pregnancy, and essential thrombocythemia (ET) can further increase this likelihood.
Although doctors often diagnose it in older adults or people with genetic mutations, roughly 1 in 3 pregnancies where ET is present end in miscarriage or spontaneous abortion in the first two trimesters. Pregnancy may not cause ET, but about 20% of people get a diagnosis of the condition during their reproductive years.
Your body undergoes a lot of changes during pregnancy. Beyond the needs of the developing fetus, your body also has to support the demands of reproduction. Increased fluid volume can dilute the nutrients and other essential elements in your body.
A drop in platelets during pregnancy isn't uncommon and usually has no lasting effect on you or your baby. If you have a diagnosis of thrombocytopenia before or during your pregnancy, talk with your healthcare team about your specific risks and what kind of monitoring you'll need.
Mandy Moore Gives Health Update On Low Platelets Issue After 1st Pregnancy
\n\nThe This Is Us actress, who welcomed her first child, August "Gus" Harrison, last month, shared her health journey via her Instagram Story after a visit to her doctor.
\n"Back at the hematologist to see if my platelets have gone up since having the baby," Moore, 36, wrote alongside a photo at the doctor's office.
\nThe Walk to Remember actress, who shares Gus with husband Taylor Goldsmith, explained that she is doing better after the visit, and inquired how others with the same issue have overcome it.
\nMandy Moore Courtesy of Mandy Moore/Instagram\n"Friends with low platelets: what has worked? I took iron, B12 and folate … and ate all the lentils and dark leafy greens, etc," she wrote via her Instagram Story after getting back to her car.
\nThe Tangled star noted that her platelets "are going up," but they're "still not great."
\nShe added: "I'm on a mission to do whatever I can to get them to a solid place, so I don't have to wonder or worry during the next pregnancy."
\n\n\nMoore revealed that she has to wait a few more months "to absolutely confirm that it's in fact ITP and wasn't gestational thrombocytopenia" but appeared to be in good spirits. ITP (immune thrombocytopenic purpura) is not usually related to pregnancy, while gestational thrombocytopenia is. Both are related to having a low blood platelet count.
\nThe Princess Diaries actress announced her baby's arrival via Instagram on February 23, writing, "Gus is here. He was punctual and arrived right on his due date, much to the delight of his parents. We were prepared to fall in love in all sorts of brand-new ways, but it goes beyond anything we could have ever imagined."
\n\n\t\t\nDespite having a "harrowing" birthing experience, Moore has since gushed about her baby's arrival and how excited she is to have another little one.\n"I've said to my husband so many times — and really anyone that has come by that will listen — I'm like, 'I can't wait to do it again,'" she said on the March 11 episode of "Dr. Berlin's Informed Pregnancy" podcast. "As harrowing as the journey was, I miss it. I'm sad that I don't get to relive it or do it again or something."\nMandy Moore attends the NBCUniversal Upfront Presentation in New York on May 13, 2019. Evan Agostini/Invision/AP/Shutterstock\nThe "When I Wasn't Watching" singer continued: "It's a hard feeling to describe, but I can look back now with such affection and fondness for myself and what that experience was because it brought me Gus. It brought me this child who is my whole world now."\nThe New Hampshire native detailed her birthing journey, revealing that she wasn't able to get an epidural because her platelets were dropping "exponentially," which was "grueling."\n\n\nAfter pushing for three hours, Moore explained that her son's heart rate began to drop and the plan of action quickly switched to get him out as soon as possible. "One second, everything was fine. Then the next second, it was like, this is happening. And literally, I pushed harder than I had. And it went from no baby to a full body out in seconds," she said.\nDespite the ups and downs of physically having Gus, the actress couldn't be happier as a new mom.\n"I've never felt this kind of love. It was like the world stopped again, and you're not aware of anything else that's going on," she added. "That's why the tearing, all of it, it doesn't exist. It doesn't matter. You just have your baby on you. And I couldn't imagine anything else mattering."","thumbnailUrl":"https://s.Yimg.Com/uu/api/res/1.2/RY2X0rktpILCG6uQ4.ZNSQ--~B/aD0xODA7dz0zMjA7YXBwaWQ9eXRhY2h5b24-/https://s.Yimg.Com/hd/cp-video-transcode/prod/2021-03/28/6060b558b2bd3f37a594da4e/6060b558b2bd3f37a594da4f_o_U_v2.Jpg","duration":"PT49S","contentUrl":"","embedUrl":"https://www.Aol.Com/entertainment/mandy-moore-gives-health-low-161349540.Html?Format=embed","identifier":"945dc260-a95b-39ea-9bf1-11dc1f71fb1d","uploadDate":"2021-03-28T16:13:49Z"}} ]]> On the mend. Mandy Moore gave fans a health update on Friday, March 26, after suffering from low blood platelets following her son's birth. Mandy Moore Shares Adorable New Photo of Baby Gus Read article The This Is Us actress, who welcomed her first child, August "Gus" Harrison, last month, shared her health journey via her Instagram Story after a visit to her doctor. "Back at the hematologist to see if my platelets have gone up since having the baby," Moore, 36, wrote alongside a photo at the doctor's office. The Walk to Remember actress, who shares Gus with husband Taylor Goldsmith, explained that she is doing better after the visit, and inquired how others with the same issue have overcome it. Mandy Moore Courtesy of Mandy Moore/Instagram "Friends with low platelets: what has worked? I took iron, B12 and folate … and ate all the lentils and dark leafy greens, etc," she wrote via her Instagram Story after getting back to her car. The Tangled star noted that her platelets "are going up," but they're "still not great." She added: "I'm on a mission to do whatever I can to get them to a solid place, so I don't have to wonder or worry during the next pregnancy." Celebrity Health Scares Through the Years Read article Moore revealed that she has to wait a few more months "to absolutely confirm that it's in fact ITP and wasn't gestational thrombocytopenia" but appeared to be in good spirits. ITP (immune thrombocytopenic purpura) is not usually related to pregnancy, while gestational thrombocytopenia is. Both are related to having a low blood platelet count. The Princess Diaries actress announced her baby's arrival via Instagram on February 23, writing, "Gus is here. He was punctual and arrived right on his due date, much to the delight of his parents. We were prepared to fall in love in all sorts of brand-new ways, but it goes beyond anything we could have ever imagined." Despite having a "harrowing" birthing experience, Moore has since gushed about her baby's arrival and how excited she is to have another little one. "I've said to my husband so many times — and really anyone that has come by that will listen — I'm like, 'I can't wait to do it again,'" she said on the March 11 episode of "Dr. Berlin's Informed Pregnancy" podcast. "As harrowing as the journey was, I miss it. I'm sad that I don't get to relive it or do it again or something." Mandy Moore attends the NBCUniversal Upfront Presentation in New York on May 13, 2019. Evan Agostini/Invision/AP/Shutterstock The "When I Wasn't Watching" singer continued: "It's a hard feeling to describe, but I can look back now with such affection and fondness for myself and what that experience was because it brought me Gus. It brought me this child who is my whole world now." The New Hampshire native detailed her birthing journey, revealing that she wasn't able to get an epidural because her platelets were dropping "exponentially," which was "grueling." Celebrity Babies of 2021: See Which Stars Gave Birth Read article After pushing for three hours, Moore explained that her son's heart rate began to drop and the plan of action quickly switched to get him out as soon as possible. "One second, everything was fine. Then the next second, it was like, this is happening. And literally, I pushed harder than I had. And it went from no baby to a full body out in seconds," she said. Despite the ups and downs of physically having Gus, the actress couldn't be happier as a new mom. "I've never felt this kind of love. It was like the world stopped again, and you're not aware of anything else that's going on," she added. "That's why the tearing, all of it, it doesn't exist. It doesn't matter. You just have your baby on you. And I couldn't imagine anything else mattering."Woman Who Went Into A Coma After Giving Birth Screamed 'where's My Baby?' When She Woke Up With A Flat Stomach And No Memory Of Labour - As Her Son Fought For His Life At ...
A mother who woke up from a coma after giving birth has recalled the heartbreak of waking up with a flat stomach and no sign of her baby.
Former midwife Robyn Davis, 28, from Steyning, West Sussex, was put in a coma after having a 20-minute seizure while in labour with her second child, Orlando.
Three days later, Robyn woke with no recollection of her birthing experience. She told the Mirror: 'I touched my stomach and it was flat, I just screamed 'Where's my baby?' I couldn't remember what had happened, I was just screaming and crying, I didn't know if I had had a boy or a girl.'
Orlando passed away at 20 days old. Robyn and her partner Jonny Davis, 30, have recalled the unthinkable experience in an inquest into the death of Orlando.
The inquest concluded on Thursday and found that medical neglect contributed to the newborn's death after his mother developed hyponatremia during labour, which went unidentified.
Robyn Davies holding Orlando, who was born by emergency caesarean section at Worthing Hospital on September 10 2021, but tragically died 14 days later
Robyn started labour at home and later travelled to the hospital. Once there, she became unwell and was incoherent.
Robyn started to experience delusions and hallucinations, meaning she could not give consent to a Caesarean before suffering a 20-minute seizure.
She suffered from a rare condition called hyponatraemia, which went undiagnosed at the time, and Jonny was told that she might not survive. Robyn was induced into a coma.
Orlando was born lifeless via Caesarean but was resuscitated after 20 minutes and transferred to a different hospital to be cared for by specialists.
Following the traumatic birthing experience, Jonny was kept in the dark about the condition of his wife or newborn child.
After Robyn woke up from the coma, she and Jonny travelled to Brighton Hospital to see their son.
It was then that the couple discovered he had cerebral palsy, was paralysed from the neck down, and was without a suck-and-swallow reflex. Multiple specialists told Robyn and Jonny that it was not in his best interest to keep him alive.
The couple told the Mirror that they were thankful to be able to take Orlando to Brighton Beach - their 'only good memories with him'. Orlando passed away the next day, aged 14 days.
An inquest delved into the care Robyn received and found medical neglect contributed to Orlando's death. The coroner found that the missed diagnosis of Robyn's condition led to her seizures, meaning Orlando had restricted oxygen access, resulting in his irreversible brain injury.
Robyn suffered from a rare condition called hyponatraemia and suffered delusions and hallucinations after going into labour
After being born, Orlando (pictured) was transferred to Brighton hospital to be cared for by specialists
Talking of the heartbreak, Robyn and Jonny have spoken of how they are living a 'life sentence' as they called for more openness in the health service.
WHAT IS HYPONATREMIA?Hyponatremia occurs when somebody's blood sodium levels are abnormally low.
Sodium regulates the amount of water in and around people's cells.
Hyponatremia causes the sodium in people's bodies to dilute, which leads to a rise in water levels and swollen cells.
Symptoms may include:
Causes can include drinking too much water, particularly during endurance events when sodium is lost through sweat.
Other causes may include taking certain medications, like antidepressants, as well as heart failure, extreme vomiting or taking the recreational drug Ecstasy.
Treatment focuses on addressing the underlying cause, if possible.
In non-serious cases this may include people altering their diets to include less water.
Severe cases may require IV fluids to slowly raise sodium levels in people's blood.
Source: Mayo Clinic
AdvertisementOrlando's parents have criticised the response by the health authorities for taking too long to investigate their son's death, which they fear could put other babies and their mothers at risk.
Mrs Davis, 28, who retrained to work in early years education said: 'I ended up in a coma and I was put in a coma for about three days.
'When I woke up, Jonny told me about what had happened and from that moment onwards my mental health has never been the same.
'We both got diagnosed with PTSD, depression, anxiety, and from a mental health point of view, we've never been the same people since it's happened. I've never been able to return to work.'
Mr Davis, 30, said: 'Myself and Robyn have been served a life sentence. No matter what the coroner deems it as, when the coronial process finishes, people go back to their jobs, people go back to their families.
'And we will come back to ours but we will come back to... One that will never be complete.'
He continued: 'We've always been a couple that plan to have a large family which we will always feel, no matter how many children, we will always feel that it's not complete.
'We still have a room in our home that is Orlando's room that will never be used for anything else.
'And it does feel like there's this vacuum and void that will never be filled. We have our newest child Nova, we adore her, and there's people who think 'Oh, well you know, they've had another child now, I'm sure that solved all of their problems', and that's not the case.'
Mrs Davis added: 'You can never move on from it because you'll hit milestones in their life and you think, 'Oh, they'll be at this age, they'll be doing that' or, 'Oh by now maybe we would have grandkids when we're older' and it's never-ending, it is definitely a lifelong sentence for sure.'
Mrs Davis added that she had stopped working with children because she found it difficult to be around young boys following Orlando's death.
She added that she still suffers a range of health issues as a result of the injuries she suffered during his birth.
Mrs Davis, a trained midwife, accused her ex-colleagues of negligence over the death of her newborn son Orlando
The couple said that they had been frustrated by the health system and the coronial process following Orlando's death which had led to them fighting for a full inquest to be held.
Mr Davis said: 'As the family, at every turn, whether it's the coronial process, whether it's a possible negligence investigation, you're actually continuously subservient to a process that you feel is drawn out and actually just continues to elongate the pain and turmoil that you're going through.
'We spent two-and-a-half years in purgatory waiting for accountability and we sit there and go 'Well, in the last two-and-a-half years, what do we think the odds are that another circumstance may have occurred and the public have been at risk?'''
Following the inquest's conclusion, the couple said they are joining calls for a national public inquiry into maternity care in England.
In a statement, they said: 'What scares us, is that this is not an isolated incident and we know of many other families going through this same agony.'
Commenting after the inquest, chief nurse Maggie Davies from University Hospitals Sussex NHS Foundation Trust, which runs Worthing Hospital, said: 'We wish to offer our sincere condolences to Orlando's family once more for the unimaginable heartache and distress caused by the loss of their baby boy.
'As the coroner noted in her findings, hyponatremia is an extremely rare condition which is little understood. We support her view that there is an urgent need for new national guidelines.
'This tragedy has deeply affected everyone involved in the family's care, and led directly to us introducing new guidance and training within our maternity service.'
Orlando was the second child of graphic designer Jonny Davis, 30 and 28 year old Mrs Davis, of Steyning, West Sussex - who have since had another baby (both pictured)
It comes after the midwife who helped deliver Orlando, who died two weeks after an emergency C-section, said she was not concerned because she thought the mother was 'hypno-birthing', an inquest has heard.
Robyn claimed she 'never felt safe' and concerns about her labour going wrong were repeatedly brushed aside during her home birth.
Mrs Davis, a trained midwife, accused her ex-colleagues of negligence over the death of her newborn son Orlando.
It was heard that her 'birth plan' did not include the increasingly popular breathing technique for pain management, hypno-birthing.
However, Gillian Goodwin, who was one of those who cared for Mrs Davis during the birth, said her behaviour was similar to mothers who use it, so she did not think the mother was in difficulty.
However, Mrs Davis ended up having to be rushed by ambulance to hospital, but had 'no-one' waiting for her when she arrived, the inquest was told. Ms Davis suffered seizures which led to her being placed in a coma.
The previously healthy baby boy tragically passed away just two weeks after being born by emergency caesarian section on September 10, 2021, despite it being initially assessed as a 'low risk' pregnancy.
The baby was born in September 2021 and died two weeks later
Ms Goodwin said that during the labour she had been worried about baby Orlando's heart rate.
'I was just really concerned the baby was not very happy and I didn't know why,' she told the inquest.
When asked what hypno-birthing was, she said: 'It is a technique that some women choose to use to help through the process of giving birth.'
Ms Goodwin told the hearing she had looked through Mrs Davis' birth plan - where there was no mention of using the technique.
'It doesn't say specifically that she wants to hypno-birth,' she said.
However, she added: 'She was acting like somebody who was hypno-birthing.
'It's all about the breathing technique.'
Orlando was the second child of graphic designer Jonny Davis, 30 and 28 year old Mrs Davis, of Steyning, West Sussex - who have since had another baby.
In light of his death, it has been alleged that there was a failure to monitor the 'fluid consumption and urine output' of Mrs Davis during labour.
At Chichester Coroner's Court, Wiltshire, Ms Goodwin - who has worked as a midwife for 17 years - said she arrived at the Davis' household at around 5pm on September 9, 2021.
Throughout the early stages, she said Mrs Davis was 'acting like a normal person in labour'.
Father Jonny is pictured hugging Orlando in the hospital
However, as the labour progressed with little progress, Mrs Davis 'became demoralised' until things deteriorated and it was decided she should be transferred to hospital.
Mrs Davis claimed her concerns about the baby's position and fluid consumption were ignored.
The hearing was told Mrs Davis was 'blue-lighted' via ambulance to Worthing Hospital, West Sussex, but nobody was waiting for them when they arrived.
Ms Goodwin said she had to go inside and fetch members of staff to start treating Mrs Davis.
She insisted she had not told a fellow midwife that Mrs Davis was using the technique during a handover of her care at the hospital.
Despite this, the inquest previously heard the midwife told a dazed Mrs Davis she was sorry and felt as if it was her fault when she woke up - 'because I just thought you were hypno-birthing'.
The solicitors of Robyn and Jonny also claim there was 'a basic lack of safe maternity care' provided for Orlando and his mother by NHS staff.
A spokesman for CL Medilaw previously told the inquest medics had 'failed' to monitor Mrs Davis's fluid consumption and urine output during labour 'despite identified concerns'.
They claim this caused the mother to have a seizure and require an emergency caesarean section to deliver Orlando, who was starved of oxygen and suffered fatal brain damage as a result.
Mrs Davis told the hearing she had previously worked as a midwife at the hospital but left because of 'stress, poor staffing and lack of support' for the midwifery team.
The couple's solicitor said they had been diagnosed with PTSD as a result of their experience
She said she had opted for a home birth with a birthing pool following the advice of her midwife.
Mrs Davis felt she had not been listened to by the midwives when she raised concerns about her fluid intake and the position of the baby.
She said: 'I proceeded to keep saying 'Something is wrong'. It felt like I was trapped, that, although I knew I was declining so rapidly, I was unable to think how I could help myself, such as asking to go to hospital.
'Every time I said something was wrong the midwives never investigated this further.'
A spokesman for CL Medilaw previously said: 'Robyn has been left with chronic ongoing health issues, and both her and Jonny have been diagnosed with PTSD as a result of their horrendous experience.'
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