Up to 1 in 5 women who have preeclampsia or eclampsia develop HELLP syndrome. Julie is an Adult Nurse Practitioner with oncology certification and a healthcare freelance writer with an interest in educating patients and the healthcare community. 2007;2:3. doi:10.1186/1750-1172-2-3, Morris VK, Spraker HL, Howard SC, Ware RE, Reiss UM. A high platelet count is not always a serious concern. 2020;15(8):e0237016. During pregnancy, sometimes platelet levels can become too low or too high. What level is a high platelet count during pregnancy? Each trimester calls for different nutritional needs due to hormonal and physiological changes. raised or high platelet count in pregnancy Last reviewed 01/2018 reactive thrombocytosis (RT) may be responsible for more than 85% of cases with thrombocythaemia causes of reactive thrombocythaemia (including inflammation, infection, haemorrhage and iron deficiency) must be excluded before a diagnosis of essential thrombocythaemia (ET) is made Our objective with respect to women who had complicated pregnancies was to determine whether there is a relationship between the identified complications and platelet counts. Certain individuals are more at risk of developing clots, including those who: Blood clots may form in any blood vessel and prevent blood from flowing properly. Thrombocytopenia in pregnancy. It usually occurs during the third trimester of pregnancy. Mogos MF, Salemi JL, Spooner KK, McFarlin BL, Salihu HH. This can increase the risk of blood clots. In women with platelet counts below 100,000 per cubic millimeter who do not have preeclampsia or a preexisting disorder associated with thrombocytopenia, a cause other than pregnancy or its complications should be considered. Women who reported having received a diagnosis of hypertension, diabetes, or cancer were excluded. Effect of pregnancy on the course of immune thrombocytopenia: a retrospective study of 118 pregnancies in 82 women. Severe IUGR can lead to intrauterine death. Platelets, or thrombocytes, are small blood cell fragments that assist in blood clotting and help stop bleeding. History of HELLP syndrome in a previous pregnancy. It can lead to serious blood and liver problems. 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. Br J Gen Pract. If you have HELLP syndrome, you may experience pain in the upper part of your belly, blurred vision, fatigue or swelling. A lock ( A locked padlock) or https:// means youve safely connected to the .gov website. 2012;59(116):1033-5.doi:10.5754/hge10032, Yan SL, Russell J, Harris NR, Senchenkova EY, Yildirim A, Granger DN. In some cases this is due to a problem that existed prior to pregnancy; in others, it comes on during pregnancy. The 255 women who could not be evaluated and were therefore deemed to be ineligible included 141 women who reported illicit-drug use, 113 women who had received treatment with glucocorticoids for an indication other than a pregnancy-related complication or a pre-existing disorder, and 1 woman who had thrombotic thrombocytopenic purpura. 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). 6 A very high platelet count can cause blood clots that can block blood flow to the embryo or fetus, while low platelet counts can cause bleeding. When we analyzed all 970 platelet count values measured during pregnancy, at the time of delivery, or both (Fig. P ublications Committee, Society for Maternal-Fetal Medicine. Curtin LR, Mohadjer LK, Dohrmann SM, et al. However, having a high platelet count can be associated with cancer. In women who have a platelet count of less than 100,000 per cubic millimeter, a cause other than pregnancy or its complications should be considered. Before You can find out more about our use, change your default settings, and withdraw your consent at any time with effect for the future by visiting Cookies Settings, which can also be found in the footer of the site. 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. Among all 15,723 deliveries that occurred at Oklahoma University Medical Center (OUMC) between January 1, 2011, and August 19, 2014, a total of 7351 women who had a platelet count measurement at the time of delivery and at least one platelet count measurement during their pregnancy were selected for inclusion in our study. The difference in the mean platelet count between the women who had no missing platelet counts and the 4232 women who had missing platelet counts during one or more trimesters was not significant (P = 0.79). 2012 Dec;4(6):415-23. doi:10.4021/jocmr1125w, Heber S, Volf I. Etiology of thrombocytosis in a general medicine population: analysis of 801 cases with emphasis on infectious causes. The National Health and Nutrition Examination Survey: sample design, 19992006. ), the HematologyOncology Section, Department of Medicine, College of Medicine (J.A.R., J.N.G. Blood. Preeclampsia can cause HELLP syndrome (hemolysis, elevated liver enzymes and low platelet count). Among all 15,385 women who had singleton pregnancies, 4760 women had pregnancy-related complications. Burrows RF, Kelton JG. An official website of the United States government. S1A and S1B in the Supplementary Appendix, Disorders associated with thrombocytopenia, Women with uncomplicated pregnancies, platelet counts <80,000 per cubic millimeter, and an alternative cause for thrombocytopenia, Women with pregnancy-related complications, Women with preexisting disorders associated with thrombocytopenia. 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). A full-term pregnancy typically lasts for 40 weeks. 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. However, having a high platelet count can lead to clotting problems and, in some cases, may be associated with serious conditions, like cancer. Every woman's platelet count falls 15 to 20 percent over the course of pregnancy. take care! Among all 15,385 women who had singleton pregnancies, 338 women had preexisting disorders that were associated with thrombocytopenia. Watson J, Jones HE, Banks J, Whiting P, Salisbury C, Hamilton W. Use of multiple inflammatory marker tests in primary care: using clinical practice research datalink to evaluate accuracy. An additional 7 women who had platelet counts of less than 80,000 per cubic millimeter had other causes for their thrombocytopenia. For most women with HELLP, symptoms improve within a few days of giving birth. Inflamm Bowel Dis. 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. . There are many types of anemia, a condition in which your blood doesn't have enough healthy red blood cells. HELLP syndrome is a separate disorder from preeclampsia as patients may not have high blood pressure or proteinuria. I bars denote 95% confidence intervals. 102: management of stillbirth. 2012;4(6):415-23. doi:10.4021/jocmr1125w, Brire JB. 10.3389/fmed.2023.1111139 Frontiers in Medicine 02 frontiersin.org 1. 1, and Table S4B in the Supplementary Appendix). Platelet counts may be even lower in women with pregnancy-related complications. March of Dimes. However, the frequencies of the pregnancy-related complications among these women were similar to U.S. population estimates.2229 Therefore, our data may accurately reflect the platelet counts in women with these pregnancy-related complications. Pregnancy loss occurs frequently in women with essential thrombocytosis, a case history by lead author Gokhan Anil, MD reports in The Female Patient. Your healthcare team will monitor your platelet count and other, Separation of the placenta from your womb, Obesity, Nutrition, and Physical Activity, Thrombotic Thrombocytopenic Purpura (TTP). Platelets may be destroyed at a higher rate in pregnancy. Platelet counts may be even lower in women with pregnancy-related complications. Platelet Counts during Pregnancy and at the Time of Delivery.*. The total white cell count will frequently be elevated in pregnancy due to increased numbers of neutrophils. In some cases, no treatment may be required. Delivering the fetus early may also be recommended. Assuming that platelet counts measured in the women during the postpartum period were similar to their platelet counts before pregnancy, mean platelet counts decreased by an estimated 17% during pregnancy. 2020;70(698):e622-e628. It is common and usually does not cause problems for the mother or baby. Abduljalil K, Furness P, Johnson TN, Rostami-Hodjegan A, Soltani H. Anatomical, physiological and metabolic changes with gestational age during normal pregnancy: a database for parameters required in physiologically based pharmacokinetic modelling. A novel approach to the assessment of variations in the human platelet count. Previous labor and delivery, with risk increasing for women who have given birth more than once before. Thrombocytopenia is a relatively common occurrence in people with sepsis, occurring in around 5-20% . This is called gestational thrombocytopenia. J Med Case Rep. 2009;3:91. doi:10.1186/1752-1947-3-91. Background: Platelet counts of less than 150,000 per cubic millimeter during uncomplicated pregnancies are described as gestational thrombocytopenia if no alternative cause is identified. Oncology Certified Nurse Practitioner and freelance healthcare writer with over a decade of medical oncology and hematology experience. Of these women, 2586 (54.3%) had sufficient data for our analyses (Fig. We recorded each womans platelet count, race or ethnic group, and age. Since your gynae suggested u to go for further tests, pls go ahead, anyways its just a blood check and it will give u piece of mind. Research suggests: Pre-term infants are often born with high platelet counts. The mean platelet count in the 8885 nonpregnant women is designated by N on the x axis. Gernsheimer T, James AH, Stasi R. How I treat thrombocytopenia in pregnancy. Panel A shows the mean platelet counts of the women who had uncomplicated pregnancies and of the nonpregnant women. doi:10.3399/bjgp19X704309. 3, and Table S2 in the Supplementary Appendix). doi:10.3399/bjgp20X710957, Manne BK, Denorme F, Middleton EA, et al. One study reported that about 11% of assigned males with high platelets and about 6% of assigned females with high platelets had cancer. Very low platelet counts can cause bleeding. Throughout their pregnancies and deliveries, 59 women (2.3%) with pregnancy-related complications had a platelet count below 100,000 per cubic millimeter, and 31 (1.2%) had a platelet count below 80,000 per cubic millimeter. Biomed Res Int. Even for those of us who are healthy, we need to find a doctor who can help us get through the emotional transitions during pregnancy and beyond. Also, your baby may have a low platelet count at birth. Burrows RF, Kelton JG. Most women who have essential thrombocythemia have normal, healthy pregnancies. Normal Platelet Value Range Negative Pregnancy Adult: 165 to 415X103/mm3X103/l or 165 to 415X109/L Pregnancy Trimester One: 174 to 391X103/mm3X103/l or 174 to 391X109/L Women who have preeclampsia or eclampsia (uncontrolled preeclampsia) have a higher risk of HELLP syndrome. Exercising moderately or as instructed by your healthcare provider. This can lead to heart attacks, strokes, and other serious complications. If you experience signs of HELLP syndrome, get care right away. HELLP (Hemolysis, Elevated Liver enzymes and Low Platelets) syndrome is a life-threatening pregnancy complication usually considered to be a variant of preeclampsia. The https:// ensures that you are connecting to the When I was pregnant, I also did some readings on pregnancy complications. Babies with IUGR have weights that are in the tenth percentile or less, and appear thin, wasted and pale, the University of Virginia explains. doi:10.1182/blood.2020007214. The .gov means its official. Read More Created for people with ongoing healthcare needs but benefits everyone. Stress enhances proinflammatory platelet activity: the impact of acute and chronic mental stress. Other high blood pressure disorders during pregnancy. government site. Both conditions usually occur during the later stages of pregnancy, or soon after childbirth. Less commonly, blurred vision or headache. Orphanet J Rare Dis. Having a high platelet count, or thrombocytosis, doesn't always indicate something serious is going on. Your healthcare team will monitor your platelet count and other symptoms during and soon after your pregnancy. Curtin LR, Mohadjer LK, Dohrmann SM, et al. That means you have the same number of platelet cells in a larger volume of blood. Once the underlying cause resolves or is managed, platelet counts generally return to normal levels. 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. Platelet counts were measured with standard electronic equipment maintained in laboratories certified by the Clinical Laboratory Improvement Amendments program and were categorized according to the following time periods: first trimester of pregnancy, 0 to 13 weeks of gestation; second trimester, 14 to 27 weeks; third trimester, 28 to 42 weeks (excluding the time within 48 hours before delivery); delivery; and postpartum period (defined as 4 to 12 weeks after delivery).