Platelets, or thrombocytes, are small blood cell fragments that assist in blood clotting and help stop bleeding. A high platelet count, or thrombocytosis, is defined as having more than 450,000 platelets per microliter of blood. ACOG practice bulletin no. The symmetric distribution of mean platelet counts seen in the nonpregnant women and also in the women with uncomplicated pregnancies in their first trimester and at the time of delivery suggests that the platelet counts of all women with uncomplicated pregnancies decrease at the same rate. 40, 41 In uncomplicated pregnancy and delivery 1% of women had a platelet count of less than 100 10 9 /L . The rate of decrease in platelet counts was similar in the two groups until the third trimester, when the decrease occurred at a greater rate in the women with pregnancy-related complications than in the women with uncomplicated pregnancies (Fig. Platelet abnormalities during colonic inflammation. Seven longitudinal studies reported a decrease in platelet counts during pregnancy, while four reported no change. HELLP (Hemolysis, Elevated Liver enzymes and Low Platelets) syndrome is a life-threatening pregnancy complication usually considered to be a variant of preeclampsia. High platelet count in pregnancy | HealthTap Online Doctor J Med Case Rep. 2009;3:91. doi:10.1186/1752-1947-3-91. A .gov website belongs to an official government organization in the United States. We excluded women who did not have platelet count measurements during pregnancy and women who reported illicit-drug use; these women may have had minimal or no prenatal care and may have been at greater risk for complications. The mean platelet count during the postpartum period did not differ significantly between the women with uncomplicated pregnancies and the nonpregnant women (P = 0.10). In general, the longer the pregnancy continues, the better the outcome for the newborn. 2010;27(5):413-9. doi:10.3109/08880011003739455, Oida T, Kano H, Mimatsu K, et al. In older children, high platelet counts are usually a result of infection and also resolve once the infection passes. This can help prevent serious bleeding during delivery. Mean platelet counts decreased during pregnancy in all the women, beginning in the first trimester. HHS Vulnerability Disclosure, Help Treatment for elevated platelet levels will vary depending on the underlying cause. Cleveland Clinic is a non-profit academic medical center. 190: gestational diabetes mellitus. The normal range for WBC count during pregnancy is between 5,000 and 15,000 cells/mcL (microliter) of blood. Some common causes of low platelets during pregnancy include gestational thrombocytopenia, pre-eclampsia, HELLP (hemolysis,elevated liver enzymes, low platelets) syndrome, immune thrombocytopenic purpura (ITP). HELLP syndrome is very rare that occurs in 0.1% to 1% of pregnancies. The mean and median platelet count values for each of the three distribution curves differed by less than 3%. I bars denote 95% confidence intervals. 155 - 409. In some cases this is due to a problem that existed prior to pregnancy; in others, it comes on during pregnancy. Figs. Paraneoplastic thrombocytosis: the secrets of tumor self-promotion. Pooling of platelets in the spleen: role in the pathogenesis of hypersplenic thrombocytopenia. Other high blood pressure disorders during pregnancy. These platelet counts were compared with those of nonpregnant women who were included in the National Health and Nutrition Examination Survey from 1999 through 2012. Sainio S, Kekomki R, Riikonen S, Teramo K. Maternal thrombocytopenia at term: a population-based study. Shown are the distribution of the mean platelet counts of the nonpregnant women and the distribution of the mean platelet counts during the first trimester (mean gestation, 8.7 weeks) and at the time of delivery in the women who had uncomplicated pregnancies. // Leaf Group Lifestyle, Causes of Brown and Yellow Vaginal Discharge, The Female Patient: Hereditary Thrombophilia and Thrombocythemia in Pregnancy, Rose SR, Petersen NJ, Gardner TJ, Hamill RJ, Trautner BW. This is called gestational thrombocytopenia. The mean platelet count in the nonpregnant women was 273,000 per cubic millimeter. Blood Platelets in Pregnancy - Pregnancy, Baby Care The HELLP syndrome: clinical issues and management: a review. The mean platelet counts in the nonpregnant women and in the women with uncomplicated pregnancies in the first trimester and at the time of delivery were normally distributed, except for a slight skew toward higher values in all three cases (Fig. This. The interaction between the mean platelet count in the women with uncomplicated pregnancies and the mean platelet count in the women with pregnancy-related complications was significant (P = 0.002), which indicated that the rates of decrease in platelet counts differed. Burrows RF, Kelton JG. In severe cases, your healthcare provider may use an ultrasound or CT scan to check for an enlarged liver or bleeding in your liver. The total white cell count will frequently be elevated in pregnancy due to increased numbers of neutrophils. take care! Treatment can help prevent symptoms and pregnancy complications. When we evaluated all 13,793 platelet count values measured during pregnancy and at the time of delivery in women with uncomplicated pregnancies (Fig. S1A and S1B in the Supplementary Appendix). Fetal intrauterine growth retardation (IUGR) complicates approximately four percent of pregnancies in women with essential thrombocytosis, Anil states. The National Health and Nutrition Examination Survey: sample design, 19992006. Thrombocytosis following splenectomy: with or without additional organ resection. Pediatr Hematol Oncol. Among the 15,723 deliveries that occurred during our study period, 7351 women had sufficient data for our analyses. Gestational thrombocytopenia: An overview - Medical News Today Less commonly, blurred vision or headache. The characteristics of these women are provided in Table S1 in the Supplementary Appendix, available with the full text of this article at NEJM.org. Pregnancy loss occurs frequently in women with essential thrombocytosis, a case history by lead author Gokhan Anil, MD reports in The Female Patient. 3, and Table S2 in the Supplementary Appendix). S2A in the Supplementary Appendix), we found that platelet counts of less than 150,000 per cubic millimeter occurred in 450 women (9.9%) at the time of delivery (Table 2). S2B in the Supplementary Appendix), we found that platelet counts of less than 150,000 per cubic millimeter occurred in 307 women (11.9%) women at the time of delivery, a percentage that was significantly greater than that in the women who had uncomplicated pregnancies (P = 0.01) (Table 2). When I was pregnant, I also did some readings on pregnancy complications. Taking certain medications is associated with high platelet counts, which is referred to as drug-induced thrombocytosis. In other cases, there may be a problem like an infection or anemia. Pregnancy-related complications that were recorded as such were hypertension or diabetes before or during pregnancy, preeclampsia, HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome, preterm birth (defined as birth before 37 weeks of gestation), stillbirth, and placental abnormalities (e.g., placental abruption, placenta previa, or placenta accreta). Research suggests: Pre-term infants are often born with high platelet counts. doi:10.3399/bjgp19X704309. Burrows RF, Kelton JG. The platelet counts in the women who had pregnancy-related complications decreased significantly throughout pregnancy (P<0.001). The two types of thrombocytosis are primary thrombocytosis and secondary thrombocytosis: A high platelet count may be found during routine blood work and more tests may be done to diagnose any associated conditions. A novel approach to the assessment of variations in the human platelet count. X 10 9 /L. But when that count drops abnormally low, there are several potential causes. But it also can develop in the first week after childbirth (postpartum preeclampsia). HELLP Syndrome. Blood. 2B). 2013;19(6):124. doi:10.1097/MIB.0b013e318281f3df, Geara A, El-imad B, Baz W, Odaimi M, El-sayegh S. Pseudoleukocytosis secondary to hepatitis C-associated cryoglobulinemia: a case report. HELLP Syndrome: Recognition and Perinatal Management | AAFP Am Fam Physician. Pulmonary edema (fluid buildup in the lungs). A reactive high platelet level could be due to a whole range of causes which include: -Acute bleeding and blood loss -Allergic reactions -Cancer -Chronic kidney failure or another kidney disorder -Exercise -Heart attack -Coronary artery bypass -Infections, including tuberculosis -Iron deficiency -Vitamin deficiency -Removal of spleen -Hemolytic Nishio et al. Up to 1 in 5 women who have preeclampsia or eclampsia develop HELLP syndrome. Other risk factors for HELLP syndrome include: Women may notice HELLP syndrome symptoms while they are pregnant or shortly after childbirth. If your platelet disorder is caused only by pregnancy, your platelet count will return to the normal range after your baby is born. A platelet count of 432 thousand is still within normal. It is common and usually does not cause problems for the mother or baby. Platelet activity fluctuates throughout pregnancy and is a normal feature of pregnancy owing to the effects of complex coagulation factors such as thromboxane, collagen and other complex proteins. Primary thrombocytosis in children. This results in increased blood volume and causes hemodilution. The site is secure. . It also may occur within 48 hours of delivery, although symptoms may take up to 7 days to be evident. Julie is an Adult Nurse Practitioner with oncology certification and a healthcare freelance writer with an interest in educating patients and the healthcare community. High Volume/Low Count means platelets are being destroyed. A full-term pregnancy typically lasts for 40 weeks. 716 likes, 34 comments - EVU BEEPE (@sacredbirthdoula) on Instagram: "~SAVE A ROSE~ Amber Rose should be here with us today, but . Verywell Health. The mean platelet counts of the 4568 women who had uncomplicated pregnancies are shown at each trimester (with the mean time of gestation when they were measured indicated on the x axis), at the time of delivery (designated by D on the x axis), and during the post-partum period (designated by PP on the x axis). Etiology of thrombocytosis in a general medicine population: analysis of 801 cases with emphasis on infectious causes. 2-4 However, counts < 100 10 9 /L, which is the definition for thrombocytopenia adopted by an International Working Group, 5 are observed in only 1% of pregnant women. . Thanks for your question! Pathophysiology, classification, and complications of common asymptomatic thrombocytosis in newborn infants. 2015;2015:165078. doi:10.1155/2015/165078, Koudouovoh-Tripp P, Hfner K, Egeter J, et al. The mean platelet count in the 8885 nonpregnant women is designated by N on the x axis. Women who reported having received a diagnosis of hypertension, diabetes, or cancer were excluded. HELLP syndrome is rarely life-threatening. While some stress is unavoidable during pregnancy, avoiding high-stress situations or learning to manage your stress is a good idea. Does flu affect platelet count. Panel B shows the mean platelet counts of the women who had uncomplicated pregnancies, the women who had pregnancy-related complications, and the women who had preexisting disorders that were associated with thrombocytopenia. Cancer incidence following a high-normal platelet count: cohort study using electronic healthcare records from English primary care. The mean platelet count at the time of delivery was higher in non-Hispanic black women than in non-Hispanic white women and Hispanic women (P<0.001) and was higher in younger women (15 to 19 years of age) than in older women (20 to 44 years of age) (P<0.001). Preeclampsia is one high blood pressure (hypertension) disorder that can occur during pregnancy. As elevated platelet counts can be an indicator of an underlying medical condition, it is highly recommended that you further consult and discuss with your doctor to address your concerns, especially if your high platelets condition is persistent. Platelet Counts: A normal platelet count in humans ranges from 150,000 to 450,000 platelets per microliter of blood tested. The platelet counts for these 12 women and the clinical data that supported their diagnoses are summarized in Table S3 in the Supplementary Appendix. Cancer can cause secondary thrombocytosis, which may be one of the first signs of certain types of cancer. Very low platelet counts can cause bleeding. What Is the Outlook for Those With High Platelet Counts? Blood loss, a lack of dietary iron, pregnancy, and intestinal diseases that affect the absorption . The pregnant women had significantly lower mean platelet counts than the nonpregnant women during each trimester and at the time of delivery (P<0.001). Surgeries and trauma can lead to a high platelet count. Regularly exercising helps maintain platelet function when at rest. A high test result means that your platelets are larger than what's considered normal. 146 - 429. The combined mean platelet counts from all studies supported the concept . Reese JA, Peck JD, McIntosh JJ, Vesely SK, George JN. Platelet counts below 80,000 per cubic millimeter occurred in 13 of the 24 women (54.2%) who had immune thrombocytopenic purpura. Copyright 2023 Leaf Group Ltd., all rights reserved. In addition, thrombocytopenia in women who have preexisting disorders, such as immune thrombocytopenic purpura, may become more severe during pregnancy.4,11 To understand the course of platelet counts throughout pregnancy, we evaluated platelet counts in women who delivered at the Oklahoma University Medical Center between 2011 and 2014. Platelet counts may be even lower in women with pregnancy-related complications. Other . Among all 15,385 women who had singleton pregnancies, 9912 women had uncomplicated pregnancies. Some platelet-lowering medications, such as anagrelide, busulfan and hydroxyurea, is embryo-toxic and should not be used in pregnancy. They may have low oxygen and blood sugar levels at birth and may have trouble maintaining their temperatures. The alternative causes for the thrombocytopenia that were identified in the other 7 women were immune thrombocytopenic purpura (2 women), pseudothrombocytopenia due to in vitro platelet clumping (2 women), error in measurement of platelet count (2 women), and hereditary thrombocytopenia (1 woman). Advertising on our site helps support our mission. What are platelets and why are they important? Pregnancy can cause your platelet count to be slightly lower than normal. Discover more about the pros, cons, and limitations on having sugar cravings when pregnant here! How I treat thrombocytopenia in pregnancy | Blood | American Society of To compare postpartum platelet counts with platelet counts at the time of delivery, we used a paired t-test. Vaccine . Thrombocytosis - Symptoms and causes - Mayo Clinic Platelet counts in all women decrease throughout pregnancy, beginning in the first trimester. However, HELLP syndrome itself does not affect the newborns liver function or other organs. Boehlen F, Hohlfeld P, Extermann P, Perneger TV, de Moerloose P. Platelet count at term pregnancy: a reappraisal of the threshold. Blood clots or bleeding may cause the following complications: Getting routine medical care during your pregnancy can help you avoid or manage these complications. In healthy, nonpregnant adult women, one third of all circulating platelets are transiently pooled within the low flow-rate circulation of the splenic sinusoids; an increased spleen size results in more pooling of the platelets and a lower platelet count.17 Therefore, the 50% increase in spleen size that occurs during pregnancy18 would also contribute to a lower platelet count. If platelet levels are too high, it may be necessary to take anti-clotting medications until the fetus is safely delivered. High platelet levels caused by primary thrombocytosis, also known as thrombocythemia, can be dangerous in pregnancy and can result in serious maternal and fetal complications. Platelets and pregnancy. To determine whether platelet counts changed significantly during gestation, whether they differed significantly among races or ethnic groups or age groups, and whether the rate of decrease during pregnancy differed significantly between women who had uncomplicated pregnancies and women who had pregnancy-related complications or preexisting disorders, we constructed linear mixed models to account for women who had repeated platelet count measurements. Platelet counts at the time of delivery in the women who had singleton pregnancies and in the women who had twin pregnancies were compared with the use of Students t-test. Inflamm Bowel Dis. Burrows RF, Kelton JG. S2C in the Supplementary Appendix), we found that platelet counts of less than 150,000 per cubic millimeter occurred in 39 women (19.8%) at the time of delivery (Table 2); 17 women (8.6%) had platelet counts of less than 80,000 per cubic millimeter (median, 48,000; range, 4000 to 77,000). HELLP Syndrome: What It Is, Symptoms & Treatment - Cleveland Clinic 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (https://rarediseases.info.nih.gov/diseases/8528/hellp-syndrome), (https://www.preeclampsia.org/hellp-syndrome). Your healthcare team will diagnose a platelet disorder based on your medical history, family history, a physical exam, and test results. Your provider will keep an eye on your blood pressure and other vital signs to catch problems like HELLP early. ), University of Oklahoma Health Sciences Center, Oklahoma City, Address reprint requests to Dr. George at the College of Public Health, University of Oklahoma Health Sciences Center, 801 NE 13th St., Oklahoma City, OK 73104, or at, The publisher's final edited version of this article is available free at, GUID:DD542CB8-3D14-4965-919B-3B02AA7E21B3. 2B). Platelet counts differ by sex, ethnicity, and age in the United States. However, the exact threshold for determining whether a high WBC count indicates leukaemia during pregnancy can vary depending on the individual case and the specific type of leukaemia. This can increase the risk of blood clots. sharing sensitive information, make sure youre on a federal Neutrophils can also demonstrate a "left shift" (increased number of band neutrophils). 166: thrombocytopenia in pregnancy. A total of 59 women (2.3%) had platelet counts below 100,000 per cubic millimeter and 31 women had platelet counts below 80,000 per cubic millimeter during pregnancy, at the time of delivery, or both, which represented a higher incidence of low platelet counts than the incidence among women who had uncomplicated pregnancies (P<0.001). Among the 4568 women with uncomplicated pregnancies whom we evaluated, 529 had a subsequent uncomplicated singleton pregnancy during our period of analysis and had a recorded platelet count at the time of delivery. Gestational thrombocytopenia is far and away the most common cause of low platelets in pregnancy, accounting for 75 to 80 percent of cases. HELLP syndrome is a separate disorder from preeclampsia as patients may not have high blood pressure or proteinuria. The small difference between the percentage of women with complicated pregnancies who had a platelet count of less than 150,000 per cubic millimeter and the percentage of women with uncomplicated pregnancies who had a platelet count of less than 150,000 per cubic millimeter may be related to our criteria for pregnancy-related complications. This article discusses the diagnosis process and treatment options for a high platelet count and any associated underlying conditions. Clinicians can identify a high platelet count through routine blood tests. Treatment for low blood platelets in pregnancy Doctors usually wait and see if the problem gets resolved on its own before going in for treatment for low blood platelets in pregnancy. Short-term, strenuous exercise can cause an increase in platelet count. Both conditions usually occur during the later stages of pregnancy, or soon after childbirth. J Clin Med Res. This severe form of preeclampsia affects . FOIA However, they can also occur with secondary thrombocytosis. and transmitted securely. Demographic data, platelet counts, medical-record numbers, and diagnosis codes identified from electronic medical records were combined into a single database. Your provider may give your baby corticosteroids to help their lungs develop. From my understanding, high blood platelets posed a high risk to both mum and fetus. Preeclampsia can cause HELLP syndrome (hemolysis, elevated liver enzymes and low platelet count). Complications that can be a result of either too high or too low platelet levels include: In most cases, platelet levels can be managed by getting routine medical care during pregnancy. Per my Dr, low is under 150142 wouldn't be crazy low. National Heart, Lung, and Blood Institute. HELLP syndrome was named by Dr. Louis Weinstein in 1982 after its characteristics: These may include: Be sure to tell your healthcare provider about all medications you are taking. It is a type of preeclampsia and has similar symptoms. However, having a high platelet count can be associated with cancer. A very high platelet count can cause blood clots that can block blood flow to your baby. Multiple physiological changes during pregnancy may contribute to lower platelet counts. In our primary analyses, we included women who had a singleton pregnancy, whose duration of gestation at the time of delivery was recorded, and who had a platelet count measurement at the time of delivery and at least one additional platelet count measurement during their pregnancy. Among the 12 women with uncomplicated pregnancies who had a platelet count below 80,000 per cubic millimeter, only 5 (0.1%, among whom the range of platelet counts was 62,000 to 78,000 per cubic millimeter; median, 65,000) were identified by medical record review as having no alternative cause for the thrombocytopenia. If you have HELLP syndrome once, your risk increases for having it again. Practice bulletin no. We recorded each womans platelet count, race or ethnic group, and age. Platelet counts as low as 43,000 per cubic millimeter4,21 were reported previously in patients with gestational thrombocytopenia, but no information describing a search for an alternative cause was provided.21 Our data suggest that, for women with an uncomplicated pregnancy who have a platelet count of less than 100,000 per cubic millimeter, a cause of thrombocytopenia other than the pregnancy itself should be considered. We analyzed the platelet counts in women 15 to 44 years of age who delivered at Oklahoma University Medical Center between January 1, 2011, and August 19, 2014. High platelet levels are either essential, or primary, meaning that an excess of platelets are being made in the bone marrow. PLoS One. HELLP syndrome is a rare pregnancy complication. Rose SR, Petersen NJ, Gardner TJ, Hamill RJ, Trautner BW. Fetal intrauterine growth retardation (IUGR) complicates approximately four percent of pregnancies in women with essential thrombocytosis, Anil states. Of the 472 women who did not have a platelet count below 150,000 per cubic millimeter in their initial pregnancy, only 21 (4.4%) had a platelet count below 150,000 per cubic millimeter at the time of delivery in their subsequent pregnancy. The differences in the mean platelet count in the subgroups of women with uncomplicated pregnancies, which were defined according to race or ethnic group and age,14 were preserved throughout pregnancy, which also suggests that the platelet counts of all the women decreased at the same rate. Thrombocytosis: Symptoms, Causes & Treatment - Cleveland Clinic On rare occasions, primary thrombocytosis can turn into certain types of cancer. 155 - 409. However, the occurrence and severity of thrombocytopenia throughout pregnancy are not defined. Whether patients are referred to us or already have a Cleveland Clinic ob/gyn, we work closely with them to offer treatment recommendations and follow-up care to help you receive the best outcome.