Low Platelets in Pregnancy: Causes, Symptoms, & Risks

Did you know that nearly 10% of pregnant women experience low platelet levels? While this is often harmless, it can sometimes indicate an underlying health issue that needs attention.

Platelets are tiny blood cells that help prevent excessive bleeding — something especially important during pregnancy and childbirth [*].

Understanding what causes low platelets, recognizing symptoms early, and knowing how to support healthy levels can give you peace of mind as you prepare for delivery.

In this article, we’ll break down everything you need to know about low platelets in pregnancy, including common causes, symptoms, potential risks, and natural ways to boost your platelet count.

What Are Platelets?

Platelets, also called thrombocytes, are tiny, disk-shaped blood cells produced in the bone marrow. Their primary function is to form clots and stop bleeding when blood vessels are damaged. They work by sticking together at the site of an injury, creating a plug that prevents excessive blood loss [*].

A normal platelet count ranges between 150,000 and 450,000 per microliter of blood. During pregnancy, it’s common for platelet levels to decrease slightly due to increased blood volume and physiological changes [*]. However, if the count drops too low, it can indicate a medical condition that requires attention.

The body constantly replenishes platelets, with a typical lifespan of about 7 - 10 days [*]. A drop in platelet levels may not always indicate a severe problem, but when levels become too low, it can increase the risk of excessive bleeding, both during pregnancy and childbirth.

What Does Low Platelets Mean in Pregnancy?

In most cases, a mild drop is completely normal and nothing to worry about. However, if levels fall too low, it can increase the risk of excessive bleeding during delivery or signal an underlying condition that needs attention. That’s why doctors monitor platelet counts closely throughout pregnancy - to keep both you and your baby safe.

Platelets play a vital role in maintaining maternal and fetal health. As the body undergoes significant cardiovascular changes during pregnancy, total blood volume increases by about 50% to support fetal development. This natural process can lead to dilutional thrombocytopenia, where platelet concentration appears lower due to higher plasma volume [*].

Additionally, the placenta produces substances that affect platelet production and function. Some conditions, such as preeclampsia and HELLP syndrome, interfere with platelet aggregation and clotting ability, increasing risks for both the mother and baby [*]. Understanding these physiological adaptations highlights why monitoring platelet levels is crucial throughout pregnancy.

During pregnancy, the immune system undergoes modifications to prevent rejection of the developing fetus. However, in some cases, these immune adjustments can lead to the destruction of platelets, as seen in conditions like immune thrombocytopenia (ITP). Additionally, hormonal changes affect the production and turnover rate of platelets, making pregnant women more susceptible to variations in platelet count [*].

What Causes Low Platelets in Pregnancy?

Several factors can contribute to low platelet levels during pregnancy. Some of the most common causes include [*]:

• Gestational Thrombocytopenia: The most common cause, affecting 75% of cases. It’s mild (platelet count stays above 100,000) and usually resolves after delivery.
• Immune Thrombocytopenia (ITP): An autoimmune disorder where the immune system attacks platelets. If severe (below 50,000), it may require treatment.
• HELLP Syndrome: A severe form of preeclampsia that requires urgent medical care. It can cause organ failure, severe bleeding, and preterm birth.
• Preeclampsia: A condition with high blood pressure and protein in the urine that can lead to low platelets and an increased risk of complications.
• Medication Side Effects: Some drugs (like blood thinners and anticonvulsants) can interfere with platelet production. Always consult your doctor before taking medications during pregnancy.
• Nutritional Deficiencies: Low levels of vitamin B12, folate, or iron can impair platelet production. A nutrient-rich diet is essential.

Symptoms of Low Platelet Count In Pregnancy

Recognizing the symptoms of low platelet counts can help expectant mothers seek timely medical attention. While mild cases may be asymptomatic, more severe reductions in platelet levels can result in [*]:

• Easy bruising and prolonged bleeding from small cuts.

• Frequent nosebleeds or bleeding gums when brushing teeth.

• Petechiae, tiny red or purple spots caused by bleeding under the skin.

• Excessive bleeding during childbirth, increasing risks for postpartum hemorrhage.

How Are Low Platelets Diagnosed?

If your doctor suspects low platelets (thrombocytopenia) during pregnancy, they will run several tests to determine why it's happening and how serious it is. Each test serves a specific purpose in diagnosing the cause.

Complete Blood Count (CBC) - First Step in Diagnosis

A CBC test is the most common way to check platelet levels. It measures the number of platelets in your blood, along with red and white blood cells.

A low platelet count (below 150,000 per microliter of blood) can indicate pregnancy-related thrombocytopenia, a mild and common condition. However, if the count drops below 100,000, it may signal an underlying issue like immune system problems or a clotting disorder [*].

2. Peripheral Blood Smear - Examining Platelet Quality

If your CBC shows low platelets, a peripheral blood smear is done. A sample of your blood is examined under a microscope to look at platelet size, shape, and clumping.

This test helps distinguish between platelet destruction and production problems. Some platelets may be abnormally small (suggesting a bone marrow disorder) or large (indicating immune system destruction). It also ensures that low readings aren’t due to platelets clumping together, which can sometimes cause a false alarm on the CBC [*].

3. Liver Function Tests (LFTs) - Checking for Liver-Related Causes

Your liver plays a crucial role in blood clotting. If your doctor suspects HELLP syndrome (a severe pregnancy complication) or preeclampsia, they will order LFTs to check for liver dysfunction.

Liver disease or conditions like HELLP syndrome can cause platelets to break down faster than usual. Elevated liver enzymes on this test can confirm if liver dysfunction is the reason for low platelet levels [*].

4. Bone Marrow Biopsy - Looking at Platelet Production

A bone marrow biopsy is only done in rare cases where doctors suspect bone marrow failure, leukemia, or another serious disorder affecting platelet production.

Platelets are made in the bone marrow, so if your body isn’t producing enough, it could indicate an underlying condition like aplastic anemia or a bone marrow disorder. This test is only necessary when platelet counts drop below 50,000 with no clear cause [*].

Other Possible Tests

Depending on your symptoms, your doctor may also order: [*].

• Coagulation tests - To check if your blood is clotting properly.

• Autoimmune tests - To rule out conditions like immune thrombocytopenic purpura (ITP), where the immune system attacks platelets.

• Viral screenings - To check for infections like hepatitis or HIV, which can lower platelet counts.

How to Increase Platelet Count During Pregnancy

Maintaining a healthy platelet count during pregnancy is essential for proper blood clotting and overall well-being. If your platelet levels are low, here are some effective ways to help increase them [*]:

1. Optimize Your Diet

A nutrient-rich diet plays a crucial role in supporting platelet production. Focus on the following:

• Increase folate intake: Folate (vitamin B9) is essential for healthy blood cell formation. Include folate-rich foods like leafy greens (spinach, kale, and romaine lettuce), beans, lentils, and citrus fruits (oranges, lemons, and grapefruits).
• Consume more vitamin B12: This vitamin is vital for red blood cell production and platelet health. Good sources include eggs, fish (such as salmon and tuna), dairy products, and fortified cereals.
• Boost iron levels: Iron deficiency can contribute to low platelet counts. Incorporate iron-rich foods like lean meats (chicken, beef, and turkey), spinach, tofu, and legumes. Pair iron-rich foods with vitamin C sources (such as bell peppers and strawberries) to enhance absorption.
• Get enough vitamin K: Vitamin K plays a role in blood clotting. Include foods like broccoli, Brussels sprouts, and dark leafy greens.

2. Stay Hydrated

Proper hydration is essential for maintaining blood volume and circulation, which directly impacts platelet function. Dehydration can lead to blood thickening, making it harder for platelets to function effectively. Aim for at least 8–10 glasses of water per day, and consider electrolyte-rich beverages like coconut water for added hydration support [*].

3. Limit Blood-Thinning Foods & Medications

Certain foods and medications can interfere with platelet function by thinning the blood, making it harder for platelets to clot properly. To help maintain a healthy platelet count [*]:

• Avoid excessive intake of natural blood thinners: These include things like garlic, ginger, and high-dose fish oil supplements. While these are beneficial in moderation, consuming them in large amounts may lower platelet function.
• Be cautious with medications: Some over-the-counter pain relievers, such as aspirin and ibuprofen, can also thin the blood. Always consult your healthcare provider before taking any medications or supplements during pregnancy.

4. Consider Medical Interventions

If your platelet count is dangerously low, medical intervention may be necessary. Your doctor may recommend [*]:

• Platelet transfusions: In severe cases, a platelet transfusion may be required to restore normal levels quickly, especially before delivery.
• Steroid therapy: Corticosteroids can help increase platelet production by suppressing the immune system if an autoimmune condition is causing the platelet drop.
• Intravenous immunoglobulin (IVIG): This treatment is sometimes used to raise platelet counts in cases of immune-related thrombocytopenia.

Platelets and Pregnancy FAQ

What happens if you have low platelets during pregnancy?

Mild cases are typically harmless, but severe drops can increase bleeding risks and require medical attention.

What is the most common cause of low platelet counts?

Gestational thrombocytopenia, which usually resolves after childbirth.

What deficiency causes low platelets?

Deficiencies in vitamin B12, folate, and iron can impact platelet production.

Is low platelets preeclampsia?

Low platelets can be a symptom of preeclampsia, especially in severe cases like HELLP syndrome.

What does the body feel like when platelets are low?

Symptoms may include easy bruising, frequent nosebleeds, bleeding gums, and petechiae.

When is platelet transfusion required?

Typically, a platelet transfusion is required if counts drop below 20,000 per microliter or in cases of severe bleeding.

What is the minimum platelet count for an epidural?

Most anesthesiologists require at least 80,000–100,000 platelets per microliter for an epidural.

How can I raise my platelet count fast?

Eating nutrient-rich foods, staying hydrated, and addressing underlying health conditions can help.

Can dehydration cause low platelets?

Yes, dehydration can affect blood volume and platelet concentration.

What not to eat when platelets are low?

Avoid excessive garlic, ginger, high-dose fish oil, and alcohol, as they can thin the blood.

What vitamins should I avoid if I have low platelets?

Avoid high doses of vitamin E and omega-3 supplements, as they can inhibit platelet function.

The Bottom Line

Low platelets during pregnancy are common and often harmless. However, if platelet levels drop too low, they can pose risks during labor and delivery.

Regular monitoring, a healthy diet, and working closely with your healthcare provider can help manage and improve your platelet count.

About MiracleCord

As labor approaches, it’s important to consider all aspects of your family’s future health, including the option to bank cord blood. Cord blood contains valuable stem cells that can be used to treat a range of diseases and conditions, such as leukemia, lymphoma, and immune disorders. Even if you’re in the final stages of pregnancy, it’s not too late to plan for cord blood banking.

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