Thrombocytopenia during pregnancy is quite common.

Thrombocytopenia is a disease in which the percentage of platelets in the blood decreases. Platelets are a type of megakaryocyte cytoplasm that does not contain a nucleus. Platelets also take part in localized inflammatory processes. The platelet membrane contains special molecules that recognize damage in blood vessels. Thus, the platelet penetrates the wall of the damaged vessel and acts as a living patch. However, the main role of platelets is still to stop bleeding. A platelet plug is formed from platelets, factors that constrict vascular walls are produced, and a system that affects the formation of a fibrin clot is activated. Platelets are produced by red bone marrow cells; under unfavorable factors, the production process is inhibited and thrombocytopenia occurs - low blood clotting. Visually, a lack of platelets manifests itself in the form of a diapedetic rash - minor bleeding. Thrombocytopenia during pregnancy is dangerous because the likelihood of hemorrhages in the organs and intracranial cavity is very high. There is also a risk of developing thrombocytopenia in the fetus. Therefore, pregnant women need to be especially responsible about taking blood tests and assessing possible risk in the absence of treatment.

The importance of platelets in the body cannot be overestimated. These are colorless small blood cells that keep it in a liquid state and ensure the normal functioning of blood vessels.

A deviation from the norm in any direction can be dangerous, since a lack of platelets reduces blood pressure, which is very dangerous during bleeding, and their excess leads to blood clots and blockage of blood vessels.

Under a microscope, platelets appear as jagged spheres. They, like all other blood cells, are formed in the bone marrow and have several forms of maturity (young, mature, old, etc.). They live relatively short: from a week to 12 days.

The main function of platelets is, of course, to stop bleeding. As soon as a vessel or capillary ruptures, these bodies accumulate at the site of the rupture, forming a plug, and thereby preventing blood loss.

At the moment of activation, the platelet develops processes that can exceed the size of the cell itself. In addition, they partly perform a transport function: they deliver nutrients to vascular cells, strengthening their walls.

If the level of platelets in the blood decreases significantly, it is important to identify this in time - the body not only becomes unprotected from bleeding, but all blood vessels are weakened due to lack of nutrients, they become fragile, which is also very dangerous.

The platelet level is included in . During the test you have to take frequent tests, so changes in the level of platelets in the blood will be noticeable.If platelets are low during pregnancy, this may be within the normal range, since during this period the normal boundaries expand.

In an adult, the platelet level is considered normal within the range of 200-400 * 109 per liter of blood. For a pregnant woman, the lower limit can drop to 150*109/l and even lower. This is not considered thrombocytopenia, because during pregnancy the amount of blood increases, it nourishes the placenta and the child, so the number of platelets does not fall, but is only distributed over a larger volume of blood.It is worth remembering that not only the number of platelets is important, but also their percentage. For example, with some, the number of immature cells in the blood increases significantly, but they cannot fully perform their functions. At the same time it will show increased amount platelets, but blood clotting will be reduced.

Reasons for the downgrade

Thrombocytopenia in a pregnant woman should be considered if the platelet level is below 150*109/l. The doctor will look at the rest of the test results and assess how low the norm and blood clotting time are.

If the platelet level is not lower than 116*109/l, it is too early to talk about anything and sound the alarm. During pregnancy, for a slight decrease there may be physiological reasons. It is also worth considering that mistakes also happen in the laboratory, especially if a lot of time has passed between donating blood and the test result itself.

If your platelet count is below normal and may be considered critical, your doctor will order further testing to determine the cause of this condition:

• HIV infection. There is always a chance that a pregnant woman is sick, so this test is taken several times during pregnancy. But even if the first test was negative, there is no guarantee that infection did not occur after that. With HIV infection, the body's immunity is weakened, and the platelet count also drops.
• Taking certain medications. Uncontrolled use of various drugs leads to changes in blood composition, and platelet levels may fall. In this case, you should adjust your medication intake.
• Leukemia. In leukemia, the production of all blood cells, including platelets, is impaired. However, it cannot be diagnosed as serious based on the platelet count alone. It is necessary to conduct a comprehensive examination of the pregnant woman.
• Viral or bacterial infection. An infection will be indicated not only by the level of platelets, it can be recognized even before. Similar infections have characteristic symptoms in the form of sore throat, cough, fever, etc. They can be dangerous to the fetus and therefore require immediate and careful treatment.

All of these diseases and conditions have different symptoms and manifest themselves in different ways, but thrombocytopenia is always associated with bleeding. The vessels become fragile, which is reflected in bleeding gums, nosebleeds, and prolonged menstruation (if we are not talking about pregnancy).

Treatment

Before prescribing, it is necessary to understand the reasons that led to a decrease in the level of platelets in the blood. Often in pregnant women, these causes do not lead to serious ones, and platelet levels are corrected with the help of medications.

The reasons can be both minor and quite serious (fetal death, bleeding, hormonal disbalance, neuropathy, etc.). Each of them separately requires specific treatment.Thrombocytopenia is most common in the second half of pregnancy, when the placenta has already formed and blood volume increases significantly.

If the platelet level is critically low, treatment must be started immediately; some cases may require hospitalization of the pregnant woman. It is necessary not only to increase the level of platelets, but also to establish the hematopoietic system. For this purpose, glucocorticosteroids are prescribed. These are hormonal medications that are often prescribed for adrenal insufficiency. Dexamethasone is often prescribed during pregnancy and has many effects, including preventing premature dilatation.

These drugs are prescribed either in tablets or by injection, gradually reducing the dose until positive dynamics appear.

If glucocorticosteroids are powerless, they resort to treatment with injections of immunoglobulins.

Usually one injection is enough, but the doctor may repeat it 2-3 times during pregnancy.In some severe cases, platelet transfusions are performed.

Useful video - Platelets: normal and abnormalities in blood tests.

Only if the condition of the woman and child is at risk, and drug treatment did not bring results, the doctor can recommend an surgical treatment option. The woman's spleen, in which most of the platelets are destroyed, is removed laparoscopically (that is, through a small hole to prevent bleeding).

As a rule, the prognosis of such treatment for mother and child is positive.It is impossible to treat a disease such as thrombocytopenia, folk remedies. Only the attending physician can prescribe medications traditional medicine, safe for the child, as maintenance therapy.

Possible complications

Thrombocytopenia - consequences of improper treatment

Usually, thrombocytopenia noticed in time in a pregnant woman is successfully treated and controlled throughout.

However, in the absence of proper treatment or in case of a serious illness that causes a decrease in platelet levels, various consequences for the body are possible:

• The most life-threatening consequence for mother and child is internal bleeding caused by the fragility of blood vessels. Bleeding can occur anywhere, including the gastrointestinal tract. Excessive bleeding can lead to death of mother and child.
• Numerous bruises appear on the woman’s body. Often they are caused by ordinary touch or appear without any impact at all. This sure sign thrombocytopenia, and not just a cosmetic defect. Bruises indicate that the blood vessels are weakened.
• Women with thrombocytopenia are also prone to uterine bleeding, which can lead to miscarriage or premature birth.
• During childbirth, a woman with this diagnosis should not undergo manipulations that could lead to brain hemorrhage in the child. This is the use of vacuum and forceps.
• Thrombocytopenia can be passed on to the child. Immediately after birth, the child is examined, blood is taken for analysis, and neurosonography is done to determine the presence of foci of hemorrhage in the brain. If it is discovered that the newborn baby's platelet count is also critically low, intravenous immunoglobulins are immediately administered.

Thrombocytopenia does not appear so often; usually they indicate a slight decrease in platelets due to changes in the body. But even when making a diagnosis and prescription, you should remain calm.

A drop in platelet levels can also be caused by stress, so during times of severe anxiety, dizziness and weakness appear, and blood flow is impaired. You should follow all the doctor’s recommendations and undergo it on time, then the risk for the mother and child will be minimized.

Thrombocytopenia: immune and non-immune – appearance, course, relief, concomitant diseases

Also called Bizzocero plaques, they are fragments of giant bone marrow cells - megakaryocytes. Their amount in human blood constantly fluctuates, and they are least observed at night. The level of platelets drops in the spring, and in women also during menstruation, but it does not go beyond what is permitted, so there is no need to talk about thrombocytopenia as such in such cases.

With heavy physical activity, staying in the mountains, or taking certain medications, the number of these blood cells in the blood, on the contrary, increases.

Platelets that circulate in the blood healthy person, are biconvex discs of oval or round shape, without processes. However, as soon as they find themselves in an unfavorable place, they begin to sharply increase in size (5-10 times) and produce pseudopodia. Such platelets stick together and form aggregates.

By sticking together (platelet factor III) and adhering to fibrin threads, platelets thus stop, that is, they participate in blood clotting.

The first reaction of blood vessels to injury is their narrowing; platelets also help in this process, which, when disintegrating and aggregating, release the active vasoconstrictor substance accumulated in them - serotonin.

The important role of blood cells in the coagulation process is difficult to overestimate, because it is they who form the blood clot, make it dense, and the resulting one is reliable, so it becomes clear why the inferiority of platelets and their reduced number attracts such close attention.

What are the clinical manifestations of decreased platelets?

One of the important characteristics of platelets is their half-life, which is 5-8 days. To maintain a constant level of blood cells, the bone marrow must replace 10-13% of the platelet mass daily, which is ensured by the normal functioning of hematopoietic stem cells. However, in some cases, the platelet count can decrease not only below acceptable limits, but also reach critical numbers, causing spontaneous bleeding (10-20 thousand per μl).

The symptoms of thrombocytopenia are difficult to miss, so the appearance of:

1. Hemorrhages into the skin and mucous membranes (ecchymoses), occurring spontaneously (mainly at night) or after microtrauma, where minor damage can cause significant hemorrhage;
2. Meno- and metrorrhagia;
3. (in rare cases - ear) and gastrointestinal bleeding, which quickly leads to anemia

are characteristic features platelet disorders.

Why do platelet levels drop?

The causes of thrombocytopenia are caused by various pathological processes in the body and can be presented in four main groups.

Group I

Thrombocytopenia, associated with insufficient education themselves platelets in bone marrow, what happens in the following conditions:

• Aplastic, when the maturation of cells of all three lineages is inhibited - megakaryocyte, red and myeloid (panmyelophthisis);
• Metastases of any tumor to the bone marrow;
• Acute and chronic;
• Megaloblastic anemia (deficiency of vitamin B12, folic acid), however, this case does not pose a particular problem, since the platelet count decreases slightly;
• Viral infections;
• Taking certain medications (thiazides, estrogens);
• Consequences of chemotherapy and radiation therapy;
• Alcohol intoxication.

Group II

Thrombocytopenia, caused by massive bleeding or increased destruction of blood platelets.

III group

Thrombocytopenia caused by violation of pool distribution platelets with their excessive accumulation in the spleen (severe splenomegaly).

IV group

Increased destruction of blood plaques without adequate compensation their bone marrow characterizes thrombocytopenia consumption, which can be called:

• Hypercoagulation, which occurs with;
• adults and children (immune and non-immune);
• Long-term use of heparin, gold, quinidine;
• Respiratory distress syndrome (RDS), which can develop in newborns (severe respiratory dysfunction in premature infants).
• Immune disorders;
• Mechanical damage to Bizzocero plaques (use of vascular prostheses);
• The formation of giant;
• Malignant neoplasms;
• Post-transfusion complications.

Relationship: pregnancy – platelets – newborn

Pregnancy, although a physiological process, is not constantly present, therefore, what is not typical for a “normal” state can happen during such a period of life. This happens with platelets, and their number can either decrease or increase.

Thrombocytopenia during pregnancy is a common phenomenon and is mainly due to a shortened life span of red blood cells. Increasing volume of circulating blood(BCV), necessary for additional blood supply, is associated with an increased consumption of platelets, which do not always keep up with the process of providing blood to the placenta and fetus.

Thrombocytopenia during pregnancy can lead to accompanying illnesses(disorders in the coagulation system, viral infections, allergies, taking medicines, in particular nephropathy, immune and autoimmune disorders) and malnutrition.

Immune thrombocytopenia during pregnancy is especially dangerous, as it can cause uteroplacental insufficiency, the consequence of which is often malnutrition and. In addition, a decrease in blood platelets can be accompanied by bleeding and even intracerebral hemorrhage in a newborn.

Immune and autoimmune diseases present in the mother can also lead to disorders of thrombocytopoiesis in newborns, which is manifested by a decrease in the number of blood cells and determines the following forms of thrombocytopenia:

1. Alloimmune or isoimmune, associated with group incompatibility between mother and fetus, when maternal antibodies enter the fetal bloodstream (neonatal);
2. Iranimmune, if the woman has idiopathic thrombocytopenia or (antibodies directed against the baby’s platelets cross the placental barrier);
3. Autoimmune thrombocytopenia, characterized by the production of antibodies to antigens of one’s own platelets;
4. Heteroimmune, resulting from the impact of a viral or other agent on the body with a change in the antigenic structure of blood cells.

Decreased platelets associated with immunity

Immune thrombocytopenia includes such forms as:

• Isoimmune or alloimmune - can be neonatal or occur as a result of blood transfusion that is incompatible by group affiliation;
• Hapten or heteroimmune (hapten is part of an antigen), resulting from the entry of a foreign antigen (viruses, drugs) into the body;
• Autoimmune thrombocytopenia is the most common and frequently encountered. A breakdown in the immune system, the nature of which, as a rule, is not established, leads to the fact that the immune system ceases to recognize its own healthy platelet and mistakes it for a “stranger,” which in turn reacts by producing antibodies against itself.

Hemorrhagic diathesis in AITP

Autoimmune thrombocytopenic purpura (AITP) is the most common form of immune thrombocytopenia. Young women (20-30 years old) are more often affected by it.

A drop in platelet levels that accompanies another disease and is part of its symptom complex is called secondary thrombocytopenia. As a symptomatic, thrombocytopenia is observed in various pathologies:

1. Collagenosis (systemic lupus erythematosus (SLE), scleroderma, dermatomyositis);
2. Acute and chronic leukemia (Waldenström's macroglobulinemia);
3. Chronic hepatitis and kidney diseases.

However, AITP, which is called essential or idiopathic thrombocytopenia ( Werlhof's disease), occurs much more often as an independent isolated disease.

This form is called idiopathic due to the fact that the cause of its occurrence remains unclear. With this pathology, platelets live not 7 days on average, but 2-3-4 hours, despite the fact that the bone marrow initially continues to produce all cells normally. However, a constant deficiency of blood cells forces the body to react and increase platelet production several times, which negatively affects the maturation of megakaryocytes.

In pregnant women, essential thrombocytopenia has a fairly favorable course, but an increase in the frequency of miscarriages is still observed. Treatment of thrombocytopenia in such a case is carried out by administering prednisolone 5-7 days before birth. The issue of obstetrics is decided on an individual basis, but more often they resort to surgery (caesarean section).

The therapeutic effect of corticosteroids is not necessarily used during pregnancy; they are also used in other cases. In addition, a positive effect was observed from intravenous administration of immunoglobulin, which reduces the rate of phagocytosis. However, with repeated relapses of the disease, preference is often given to splenectomy (removal of the spleen).

Immune thrombocytopenic purpura in children and other types of ITP

Acute AITP in children is observed at the age of 2-9 years and occurs 1-3 weeks after a viral infection. In a child with complete well-being, petechiae and purpura suddenly appear. For this condition, the characteristic blood picture is thrombocytopenia, and there is no decrease in the level of white blood cells ().

The pathogenesis of this disease is based on the production of antibodies against antigens of viral proteins.. In this case, viral antigens or entire antigen-antibody immune complexes are adsorbed on the platelet membrane. Since viral antigens must still leave the body, which is what happens in most cases, the disease goes away on its own within two to six weeks.

Other forms of immune thrombocytopenia include a rare but serious disease called - post-transfusion purpura. Its development is based on a blood transfusion about a week ago from a donor who was positive for one of the platelet antigens, which the recipient did not have. This disorder is manifested by severe refractory thrombocytopenia, anemia and bleeding, which often leads to intracranial hemorrhage, leading to the death of the patient.

Another significant type of immune thrombocytopenia is caused by the interaction of a drug and a component of the platelet membrane - one of the glycoproteins, where the drug or glycoprotein, or their complex may appear immunogenic. A frequent cause of the development of immune thrombocytopenia may not even be the drug itself, but its metabolite. Heparin-induced thrombocytopenia has this nature. Quinine and quinidine are also typical agents capable of inducing pathology. It is interesting that such a reaction to some (specific) drugs is genetic; for example, taking products containing gold stimulates the formation of antibodies to platelets.

Non-immune thrombocytopenia

Non-immune thrombocytopenia occupy approximately a fifth of the total number of diseases associated with a decrease in the level of blood cells and are caused by:

• Mechanical injury to platelets (hemangiomas, splenomegaly);
• Inhibition of bone marrow cell proliferation (aplastic anemia, chemical or radiation damage to myelopoiesis);
• Increased consumption of platelets (DIC syndrome, deficiency of vitamin B12 and folic acid).

Besides, thrombocytopenia of non-immune origin observed in some forms of acquired hemolytic anemia, where the most significant are two forms thrombocytopenia consumption:

1. Thrombotic purpura (TPP);
2. Hemolytic-uremic syndrome (HUS).

A typical feature of these diseases is the deposition of hyaline blood clots formed as a result of spontaneous aggregation platelets, in terminal arterioles and capillaries.

Thrombotic thrombocytopenic purpura and hemolytic uremic syndrome are thrombocytopenias of unknown origin and are characterized by an acute onset of the pathological process, which is accompanied by severe thrombocytopenia and hemolytic anemia, fever, severe neurological symptoms and renal failure, which can cause short term bring to death.

Thrombotic thrombocytopenic purpura is more typical for adults and occurs after a bacterial or viral infection, immunization, is often observed in HIV-infected patients, and can also appear during pregnancy, when taking oral contraceptives or when administering anticancer drugs. There are known cases of TTP developing as a hereditary disease.

Hemolytic-uremic syndrome more common in children. The cause of this condition is the microorganisms Shigella dysenteriae or enterotoxic Escherichia coli, which destroy the endothelial cells of the renal capillaries. As a result, a large number of von Willebrand factor multimers are sent into the vascular bed, which leads to platelet aggregation.

The first manifestation of this pathology is bloody diarrhea caused by the above microorganisms, and then develops acute renal failure(formation of hyaline blood clots in the vessels of the kidneys), which is main clinical sign of the disease.

Treatment of thrombocytopenia

Acute forms

Treat thrombocytopenia in acute period follows in the hospital, where the patient is hospitalized. Strict bed rest is prescribed until the physiological level (150 thousand per μl) of platelets is reached.

At the first stage of treatment, the patient is prescribed corticosteroid drugs, which he takes for up to 3 months; removal of the spleen, if there is no choice, is planned at the second stage and the third stage of treatment is provided for patients after splenectomy. It consists of the use of small doses of prednisolone and therapeutic plasmapheresis.

As a rule, intravenous infusions of donor platelets are avoided, especially in cases immune thrombocytopenia due to the risk of aggravating the process.

Platelet transfusions provide a remarkable therapeutic effect if they are specially selected (specifically for this patient) according to the systemHLA, however, this procedure is very labor-intensive and inaccessible, therefore, with deep anemia, it is preferable to transfuse thawed, washed red blood cells.

It should be remembered that drugs that interfere with the aggregation abilities of blood cells(aspirin, caffeine, barbiturates, etc.) are prohibited for a patient with thrombocytopenia, which, as a rule, the doctor warns him about upon discharge from the hospital.

Further treatment

Patients with thrombocytopenia require further monitoring by a hematologist and after discharge from the hospital. A patient who needs sanitation of all foci of infection and deworming is given them, he is informed that ARVI and exacerbation of concomitant diseases provoke a corresponding platelet reaction, therefore hardening and physical therapy, although they should be mandatory, are introduced gradually and carefully.

In addition, patient management is provided food diary, where nutrition for thrombocytopenia is carefully described. Injuries, overloads, and uncontrolled intake of seemingly harmless medications and foods can trigger a relapse of the disease, although the prognosis for it is usually favorable.

The diet for thrombocytopenia is aimed at eliminating allergenic products and saturating the diet with B vitamins (B12), folic acid, vitamin K, which takes part in the process of blood clotting.

Prescribed in the hospital should be continued at home with eggs, chocolate, green tea and don’t get carried away with coffee. It is very good to remember at home about folk remedies for combating thrombocytopenia, so herbs with hemostatic properties (nettle, shepherd’s purse, yarrow, arnica) should be stored in advance and used at home. Infusions of complex herbal infusions are very popular. They even official medicine recommends. They say it helps a lot.

Video: thrombocytopenia and hemorrhagic syndrome

Thrombocytopenia during pregnancy is diagnosed in 7% of women and develops most often in the last trimester. The mechanism of occurrence of this pathology has not been fully studied. In 70% of cases, this condition is associated with changes in the body that occur after conception.

General information

Thrombocytopenia is a blood disorder characterized by (formed from red bone marrow giant cells). What is the role of these cells? If a wound forms in the body, a large number of platelets rush to it to “seal it.” Then changes occur in the plates themselves and the aggregation of new cells instead of those previously used to close the wound. With this disease, platelets are either quickly destroyed or synthesized in small quantities.

In the body of a healthy woman in the absence of pregnancy, the number of these cells varies from 200 to 300x10 9 /l. Their lifespan does not exceed seven days, then they are disposed of in the liver or spleen. If the number of these cells noticeably decreases, the woman is diagnosed with thrombocytopenia during pregnancy (the norm is 150x10 9 / l for a pregnant woman). Doctors sound the alarm when this figure is below 140x10 9 /l.

The main one is participation in blood clotting - an important protective reaction of the body. In addition, these tiny cells contribute to the nutrition of the inner lining of the artery, which ensures its elasticity and resistance to various types of external damage.

Pregnant women often encounter this pathology. However, it does not always carry a danger to the fetus and manifests itself with negative consequences.

Main reasons

Thrombocytopenia during pregnancy is a relatively common occurrence. It can develop due to many reasons:

• Changes at the hormonal level.
• Increase
• Nephropathy.
• Poor nutrition and vitamin B12 deficiency.
• Viral infections.
• Allergic reactions and systemic illnesses.
• Placental abruption.
• Taking certain groups of medications.

A sharp decrease in the number of platelets can be of a physiological nature, that is, it can be insignificant (at least 140x10 9 / l). As a rule, this condition does not have obvious symptoms and is detected only during a routine examination. In this case, no treatment is required, but constant monitoring of tests is necessary. In the case of a pathological variant of the disease, the doctor must first establish the cause of the pathology and immediately prescribe treatment. Otherwise, the risk of developing quite dangerous complications increases.

Clinical picture

Thrombocytopenia during pregnancy has a more vivid and varied description of symptoms than in other patients. For women in this position it is typical:

• The appearance of small hematomas on skin after touching.
• Bleeding from the uterine cavity.
• Nose and gum bleeding. This symptom cannot be called specific, since many pregnant women develop an inflammatory process against the background of a deficiency of vitamins and minerals in the gum area.

These are the clinical manifestations that accompany thrombocytopenia during pregnancy. Photos of patients who had to face such a diagnosis are presented in abundance in specialized medical reference books and other resources on related topics.

Symptoms of this disease indicate serious disturbances in the hematopoietic process. This is really dangerous, and not only during pregnancy, but also during childbirth. Lack of proper treatment can cost the life of even the most pregnant woman.

Secondary thrombocytopenia during pregnancy

Secondary thrombocytopenia is more often diagnosed in mid-pregnancy. As a rule, in this case, the disease develops as a result of irradiation of the body, poisoning with toxic substances. In addition, a decrease in platelet count may occur due to the use of certain medications. The disease is very dangerous for the child, but with timely diagnosis and timely treatment, the prognosis in most cases is favorable for both the child and the mother.

Diagnostics

Confirmation of the disease is primarily based on laboratory tests. It consists of several stages:

• Anamnesis collection.
• Medical examination.
• Blood analysis.
• bone marrow.

A blood test is the most informative method for determining the quantitative content of platelets. If, during a medical examination, obvious symptoms of the disease are revealed (a rash on the body, minor hemorrhages), then the doctor may additionally prescribe. If a large number of megakaryocytes predominate in the smear, platelets are most likely destroyed or accumulate in the spleen. Only after all of the above diagnostic measures is thrombocytopenia during pregnancy confirmed. Treatment is prescribed on an individual basis, based on the general condition of the patient and fetus.

Conservative therapy

Cases of the development of this disease, when there is a likelihood of serious consequences, are quite rare. If the pathology is accompanied by a slight decrease in platelets, there are no significant immune disorders in the body, and no special therapy is required. Thrombocytopenia during pregnancy with critical parameters requires treatment only in a hospital setting with mandatory bed rest until quantitative blood parameters return to normal. Special therapy is required only in severe forms of the disease, when the platelet count drops to 20x10 9 / l. As a rule, women are prescribed glucocorticoids. An excellent option is Prednisolone. To minimize the negative impact on the fetus, in each specific case the doctor selects the dosage and duration of taking the drug.

Severe variants of the disease, when drug therapy is ineffective, surgery to remove the spleen is recommended.

Today, Western specialists are actively developing new drugs aimed at combating pathologies such as thrombocytopenia during pregnancy. Reviews about them are still mixed. It is known that these drugs contain a substance that stimulates the production of megakaryocytes.

Help from traditional medicine

Doctors today recommend conservative therapy as one of the main ways to combat thrombocytopenia. During pregnancy, treatment with folk remedies is also actively used. It is important to note that our grandmothers’ recipes are best used in conjunction with medicines and only under the supervision of a doctor.

On the positive side, the most common beets have proven themselves in the fight against this pathology. Before going to bed, it is recommended to grate it and sprinkle it with sugar. In the morning you should squeeze the juice from the pulp and consume it on an empty stomach. Despite the fact that the taste of such a “medicine” is far from the most pleasant, the result is worth it.

Sesame oil not only regulates the number of platelets in the blood, but also accelerates blood clotting. For treatment, it is enough to add oil to salads when cooking.

Thrombocytopenia during pregnancy: consequences and prognosis

In general, the prognosis for this disease is favorable. In half of the cases it is explained by hormonal changes in the body, which is quite natural for this period.

The greatest danger is during pregnancy. What does it mean? The woman's antibodies pass through the placenta into the blood of the fetus, causing platelet death. In this case, after confirmation of the diagnosis, any obstetric intervention and operations during childbirth are prohibited. The thing is that such surgical procedures can cause intracranial hemorrhage in the baby.

Childbirth with an uncomplicated disease is carried out using a conservative method. If appropriate treatment does not produce results or the pregnant woman’s general condition worsens, a decision is usually made to caesarean section. This approach allows you to protect the fetus from injury and control possible blood loss during childbirth.

Prevention

To prevent the development of a pathology such as thrombocytopenia during pregnancy, it is necessary to minimize all factors responsible for dysfunction immune system women. It is recommended to isolate her from patients with various types of infections. It is very important during the period of bearing a baby to stop taking certain groups of medications (antitumor drugs, sulfonamides, anticoagulants, etc.). You should also protect your body as much as possible from exposure to toxic substances and radiation. On early stages During pregnancy, a consultation with a geneticist and hematologist is additionally prescribed if similar cases of the disease have already been recorded in the family.

Conclusion

This article provides detailed information on the topic “Thrombocytopenia: causes during pregnancy, main symptoms and treatment methods.” Competent and timely therapy allows you to forget about this pathology forever. Be healthy!

Cardiologist

Higher education:

Cardiologist

Kabardino-Balkarian State University named after. HM. Berbekova, Faculty of Medicine (KBSU)

Level of education – Specialist

Additional education:

"Cardiology"

State educational institution "Institute for Advanced Medical Studies" of the Ministry of Health and Social Development of Chuvashia

Women encounter such a diagnosis as thrombocytopenia during pregnancy in 1-2% of cases. This usually happens during the third trimester. For medicine, it is still completely unknown how this pathology occurs. In 70% of patients, the causes are regulated on the basis of changes that occur in the body from the moment of conception and later.

How is thrombocytopenia determined during pregnancy?

By definition, thrombocytopenia is usually a blood disease caused by the fact that platelets appear at low levels in tests. These in turn are produced by giant red cells, which form red bone marrow. Each element has its own purpose, which is worth learning about further.

Nuances of the role of platelets for the body

When a wound forms, platelets rush to the damaged area large quantities so that the vessel becomes clogged. This is the function of protecting the circulatory system and the entire body from blood loss and infection. For the human body, there is a risk of large blood loss, because the structure of the plates, with the aggregation of newly formed cells, is located in the place of those that have already used up their resource. In the presence of the disease, thrombocytopenic insufficiency, platelets are destroyed, and their synthesis drops sharply.

As for the size, for every liter of blood there is about 200-300 * 10 9. The vital limit of the cells reaches after 7 days; the recycling process occurs when it enters the liver or spleen.

Due to the smallest cells, the internal particles of the vessels, called intima, are nourished. This is necessary to achieve and maintain elasticity and resistance to external damage. With a deficiency of thrombosing cells, processes appear in which the intensity of cell production decreases, and perhaps is intensively destroyed, or is unevenly distributed. So, even if the norm is revealed by analysis, for one part of the body the indicator may remain normal, while for another it may be in deficit.

Cause-and-effect relationship of the disease in pregnant women

There are the following circumstances from which the causes of illness in pregnant women occur:

• The process of hormonal changes leads to a reduction in the lifespan of platelets;
• As the blood required for circulation increases, the relative number of platelets decreases;
• Improper diet, followed by a deficiency of follates with B12;
• Nephromatic manifestations with eclampsia and preeclampsia;
• Infection;
• The development of autoimmune thrombocytopenia begins after the body’s own immunity is activated to platelets.

Also among the circumstances there is a risk of allergies, systemic disease, and the development of obstetric hemorrhage with placental abruption. As a result of intrauterine fetal death, thrombocytopenia in pregnant women can also occur, as with the use of potent drugs or intoxication.

How to determine the disease in a pregnant woman?

Being in a position, sick ladies suffer much differently from ordinary people. For them the process is accompanied by:

• Bruises at the touch, or for no reason;
• The appearance of blood in the nasal passages, gums;
• Bleeding in the gastrointestinal tract, as well as in hemorrhoids and anal fissures;
• Hemorrhages at the small cell level, preferably along the anterior surface of the body with the limbs;
• Uterine blood loss.

There are a number of threats that are worth paying attention to Special attention.

Without rendering medical care Thrombocytopenia during pregnancy causes a number of problems during pregnancy itself, as well as during the delivery process. The thing to worry about is that the blood loss becomes high and the patient dies. You should also beware of how newborns begin to suffer from the same disease. During labor, it is unacceptable to use anything that will have an effect on the baby, as in cases of obtaining for analysis by vacuum extraction or applying forceps. He is also susceptible to intracranial hemorrhage, which is checked by neurosonography, that is, ultrasound. Umbilical cord blood is also examined, testing the contents for platelets. If the amount is critically small, immunoglobulin and platelet masses are administered. In addition, the disease can become secondary. Then it is important not to miss the moment and conduct a timely examination of the patient in order to save her life and the baby too.

What to do next?

When a disease is detected, you should not sit with your hands down. Diagnosis is carried out using various classical methods, step by step:

• Taking anamnesis;
• Examination by a doctor;
• Blood test;
• Aspiration biopsy (examine the bone marrow).

Further, depending on the severity, treatment is prescribed with conservative methods, folk remedies or other more effective options. So, if it is necessary to remove the spleen, it becomes possible to use special drugs. However, they have different reviews, which is also worth considering when making a decision.

Preventive measures for risk groups

Anyone who has already experienced the disease under study - thrombocytopenia during pregnancy, or has had women in the family who were diagnosed during pregnancy, should approach the perinatal period with caution. During these weeks, you need to pay special attention to a number of factors that contribute to immune dysfunction. They should simply be excluded. A woman should avoid infected people, regardless of the type of infection. In addition, it is important not to take certain medications that contain toxic substances and radiation. If childbirth is soon, then you need to choose a caesarean section as a less traumatic method for the baby.

As a natural therapy, it is worth using nettle with yarrow, and regularly consumed green apples will contribute to hematopoiesis. So, following the recommendations of your doctor, it will be easier to do everything necessary to bear a healthy baby.