Gestational Thrombocytopenia

I had a 33 week dr. appt today. I was doing good.. :) I have gained 27lbs so far.. which I am perfectly happy about. I truly did not want to gain more than 30, but if I do- I do. I am not letting it stress me out. And anyone that knows me, well you know how hard that is for me. So I go into the room to get weighed and my blood pressure. As the sweet Japanese lady was asking me questions "are you abused" "are you hurt" "do you want to hurt yourself" lol.. everytime they ask these.. lol. I was looking at my chart. There was a piece of paper that said PROBLEM with a blue sticky that said- "discuss with patient".... All I could read from the paper was Gestational. I could not make any of the other words out. So, we walk out- grab Nate and go sit in the room waiting for the DR. I told Nate that something was wrong and I told him what I saw.. of course he said it was not a big deal. I couldnt help but worry. Nate thought it was crazy that I was worrying so much. But I was. In my heart I knew that if it was something SERIOUS that I would have already heard from them... but I just kept thinking- what if I am hurting this baby by not eating good enough, working out, etc. It has been the most perfect pregnancy. NO complaints.. I couldnt help but worry. Luckily the DR didnt make us wait too terribly long! He comes in, says hello- and asks if we have any questions or concerns.. We did want to talk abotu circumcision, but we said no.. then I was like, "Yes, that paper in my file"... he looked at it and explained that I have gestational thrombocytopenia.

What is that? Pretty much-- my platelet count is low. A normal pregnant lady has above 150,000 where mine is in the 130,000.. nothing too bad he said. We will do blood work again in three weeks... and then again at the time of labor. The main thing it can affect is the possiblity of me not being able to get a epidural. I could only laugh inside when he said that.. because I trulyl want to do this natural.. but I am not crazy to say YES, ABSOLUTLY.. NO EPI.. because I might have too. I told Nate- my luck would be now.. I wont have a choice. Let's hope not. that is only if it gets below 100,000. But for anyone that wants more info.. here is some:

Gestational thrombocytopenia (GT) is also known as essential thrombocytopenia, benign thrombocytopenia, and incidental thrombocytopenia of pregnancy.

Incidence

The incidence of gestational thrombocytopenia is 8% of all pregnancies and accounts for more than 70% of cases of thrombocytopenia in pregnancy.

Pathophysiology

The pathophysiology of gestational thrombocytopenia is unknown, but 2 main factors are associated with GT.

Accelerated platelet activation is suspected to occur at placental circulation.
Accelerated consumption of platelets is due to the reduced lifespan of platelets during pregnancy.
Diagnosis

Asymptomatic patient with no history of abnormal bleeding.
Mild thrombocytopenia (counts >70,000/μL)
Usually detected incidentally on routine prenatal screening.
No specific diagnostic tests to definitively distinguish gestational thrombocytopenia from mild ITP.
Usually develops in the third trimester.
Lescale evaluated 8 different platelet antibodies in 250 gravidas with thrombocytopenia (160 with presumed GT, 90 with ITP) to determine if any antibodies could distinguish the 2 conditions. Platelet-associated IgG was comparably elevated in most women with GT (69.5%) and ITP (64.6%), P =0.24. A significantly higher proportion of patients with ITP had indirect IgG compared with patients with GT (85.9% vs 60.3%, P <0.001), but significant overlap existed, limiting its clinical value. Antiplatelet antibody tests, either alone or in combination, cannot be used to distinguish ITP from GT.2
Clinical manifestations

No prepregnancy history of low platelets or abnormal bleeding.
Platelet counts normalize within 2-12 weeks following delivery.
Burrows reported that all women with GT had normal or normalizing platelet counts by the seventh postpartum day.3
Fetal/neonatal risks

No pathological significance for the mother or fetus.
No risk for fetal hemorrhage or bleeding complications.
Samuels evaluated 162 pregnant women and their infants with thrombocytopenia, 74 with presumed GT. No infant from a GT gravida had a platelet count <50,000/μL or intracranial hemorrhage.4
In Burrows' large 1993 study, 756 of 1027 women who were thrombocytopenic (73.6%) had GT. Only 1 infant had a platelet count <50,000/μL, and this infant had trisomy 21 and congenital bone marrow dysfunction. Burrows concluded that GT is the most frequent type of thrombocytopenia and poses no apparent risks for either the mother or infant at delivery.