Hematologist
CION Cancer Clinics
ITP in pregnancy: how it is managed | CION Cancer Clinics
Most women with ITP go through pregnancy and delivery safely, and many need no treatment until close to the birth. Your platelet count is checked more often as pregnancy goes on. Treatment is usually used only if the count falls very low, if you bleed, or to make delivery and an epidural safer. Your baby's count is checked after birth, because it can dip for a few days. At CION Cancer Clinics, our haematologist cares for anaemia, bleeding, clotting and inherited blood disorders, with ArogyaSri, CGHS and cashless insurance accepted.
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Medically reviewed by Dr. Basudev PokhrelConsultant Haematologist · last reviewed September 2026, next review due September 2027
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On this page
- Can I have a safe pregnancy with ITP?
- Is it ITP or a low count caused by pregnancy?
- What treatment is used for ITP in pregnancy?
- What happens from the first scan to after the birth?
- Will I need a caesarean, and will my baby be affected?
- What do families worry about, and what is true?
- Common questions about ITP in pregnancy
The short answer
Can I have a safe pregnancy with ITP?
In most cases, yes. Most women with ITP carry a pregnancy to term and deliver safely, and many need no treatment until close to the birth. What changes is how closely you are watched.
What ITP means in pregnancy
ITP stands for immune thrombocytopenia. In plain words, your immune system removes platelets faster than your body makes them. Platelets are the cells that help blood clot. Some women have ITP before they become pregnant. Others are first found to have a low count on a routine pregnancy blood test.
Why the count often drifts down
Pregnancy itself tends to lower the platelet count a little, because your blood volume grows. In a woman who already has ITP, the count may fall further as pregnancy goes on. That is expected, and it is the reason your blood counts are checked more often in the later months.
Who looks after you
You need two teams talking to each other: your obstetrician and a haematologist, a doctor for blood conditions. The anaesthetist should also know about your ITP well before your due date. At CION, the haematology team reads your reports and works alongside your obstetrician. We do not replace your maternity care.
Do not stop or change any medicine you already take for ITP because you are pregnant. Ask your haematologist first.
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When to go to the emergency department now
Go to the nearest emergency department or labour ward straight away, or call 108, if you have any bleeding from the vagina, a severe headache, a fall or a blow to the stomach or head, a nosebleed that will not stop, blood in your urine or stool, or black stools. Say that you are pregnant and have ITP, and show your latest blood report. Do not wait for your next antenatal visit.
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Is it ITP or a low count caused by pregnancy?
A mildly low count in pregnancy is common and is often not ITP. Your doctor looks at the whole picture before giving it a name.
Low count from pregnancy itself
ITP
Usually a mild drop, found late in pregnancy
Can be lower, and may be found at any stage
No earlier history of a low count
Often a low count known before pregnancy
Returns to normal after delivery
May stay low after delivery
Does not affect the baby's count
Can lower the baby's count for a short time
Treatment choices
What treatment is used for ITP in pregnancy?
The choice rests on bleeding, how low the count is, and how close you are to delivery. Your haematologist sets it with your obstetrician.
Careful watching
If you are not bleeding and the count is not very low, regular blood tests may be all you need for most of the pregnancy.
Not suitable if you are bleeding, or if delivery is near and the count is too low for an epidural.Steroid tablets
Medicines such as prednisolone can raise the count. They are often a first choice in pregnancy. Side effects to watch include raised blood sugar, raised blood pressure and weight gain.
May not suit you if you have diabetes in pregnancy or high blood pressure. Your team will decide.IVIG drip
IVIG is an antibody product given through a vein. It can raise the count fairly quickly, so it is often used close to delivery.
The rise usually lasts only a few weeks, so timing matters.What is usually avoided
Some ITP medicines are not normally used during pregnancy because of possible effects on the baby, or because there is too little safety information.
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- Which of your current medicines are safe now
- Painkillers to avoid, such as aspirin
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The pathway
What happens from the first scan to after the birth?
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Early pregnancy
Tell your obstetrician about your ITP at the first visit, and bring every old blood report. If the low count is new, tests are done to look for other causes, such as infection, thyroid or liver problems, or blood pressure conditions of pregnancy.
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The middle months
Your count is checked at regular antenatal visits. If it is steady and you are not bleeding, most women simply carry on with normal care.
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Planning for delivery
In the final stretch, checks become more frequent. You should meet the anaesthetist to talk about whether an epidural or spinal injection will be possible. Treatment may be started now to raise the count before labour.
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The birth
Deliver in a hospital with a blood bank and a newborn unit. Platelets should be available if needed. Your team avoids tools that could injure the baby's head where they can.
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After the birth
Your baby's platelet count is checked, and checked again over the next few days. You are watched for heavy bleeding after delivery.
Delivery and your baby
Will I need a caesarean, and will my baby be affected?
ITP on its own is not usually a reason for a caesarean. The way you deliver is decided on the same grounds as for any other pregnancy. A caesarean is major surgery and carries its own bleeding risk.
Epidural and spinal pain relief
An epidural needs a needle placed near the spine. If the platelet count is too low, a bleed there could press on the nerves, so the anaesthetist may advise against it. That is why the count is checked close to labour, and why treatment is sometimes given beforehand. If an epidural is not possible, other forms of pain relief are available.
What happens with the baby's count
The antibodies that cause ITP can cross the placenta. Most babies are born with a normal or only mildly low count. A small number have a low count that dips further over the first few days. Serious bleeding in the baby is rare. The newborn team checks the count and treats the baby if needed. It usually recovers on its own.
What this page cannot tell you
Your own count, your baby's count at birth and the right plan for your delivery cannot be predicted from a general page. Reference ranges also differ between laboratories, and one result is always read alongside symptoms and repeat tests.
Commonly believed
What do families worry about, and what is true?
"With ITP, she should not become pregnant at all."
Most women with ITP have healthy pregnancies. Planning ahead helps. Talk to your haematologist before trying, so that medicines can be reviewed and the count is known.
"Steroids in pregnancy will harm the baby."
Steroid tablets are among the medicines used most often for ITP in pregnancy. They do have side effects for the mother, and your team will watch for them. Stopping them suddenly on your own can be harmful.
"Papaya leaf juice will fix her platelets."
There is no good evidence that papaya leaf or goat's milk treats ITP. Some herbal products are not known to be safe in pregnancy. Ask your doctor before taking anything.
"A low count means the baby must be delivered early."
ITP alone is rarely a reason to deliver early. Timing is planned around the health of mother and baby, not around one blood result.
Questions we are asked
Common questions about ITP in pregnancy
My platelet count was low on a pregnancy blood test. Do I have ITP?
Not necessarily. A mild drop is common in pregnancy and often settles after the birth. Your doctor will look at how low the count is, when it was found, your earlier reports and other tests. A haematologist may be asked to see you if the count is lower than expected or you have bleeding.
Can I breastfeed if I have ITP?
Yes, in most cases. ITP itself is not a reason to avoid breastfeeding. Some ITP medicines pass into breast milk, so ask your haematologist whether the medicine you are on suits breastfeeding. Do not stop a medicine on your own to breastfeed.
Can I take aspirin or painkillers while pregnant with ITP?
Ask before taking any painkiller. Aspirin and similar medicines can affect how platelets work and may raise the bleeding risk. Paracetamol is often suggested for pain, but your doctor should confirm it for you. If aspirin was prescribed for another reason, do not stop it yourself. Discuss it with both teams.
Will my baby have ITP for life?
No. A low count in the baby comes from your antibodies crossing the placenta, and these clear from the baby's blood over time. The count usually recovers without lasting effects. Your baby does not develop ITP from this, though the newborn team will check the count until it is safe.
Does ITP get worse after pregnancy?
For many women the count goes back to where it was before pregnancy. For some it stays low for a while. Keep your follow-up visits with your haematologist after delivery. A repeat count helps decide whether any medicine used during pregnancy is still needed.
Will ITP come back in my next pregnancy?
It can. Women with ITP often have a low count again in a later pregnancy, and a baby affected once may be affected again. Tell your team about the last pregnancy, including your baby's count. It helps them plan earlier checks.
Where should I plan to deliver?
Choose a hospital with a round-the-clock blood bank, an anaesthetist on site and a newborn unit. Ask whether the obstetric team has looked after women with ITP. If you live in a district far from Hyderabad, plan your route and back-up hospital well before your due date.
Is ITP care in pregnancy covered by Aarogyasri or insurance?
Often yes, for approved treatment. Aarogyasri, PM-JAY, CGHS, ECHS and EHS may cover parts of care, and most cashless insurers cover inpatient treatment. Scheme rules change, so check your current cover. The CION helpline can help you check before a visit.
Your Haematologist
Meet CION's haematologist. One specialist for your blood report and your plan.
Dr. Basudev Pokhrel reviews blood counts, transfusion needs and blood disorders, and works with the CION tumour board on blood cancers.
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Where to find us
Our centres in and around Hyderabad
Addressed by landmark, because that is how this city navigates. A haematology consultation can be booked at any of these centres through one helpline, and your team will tell you where each test or treatment takes place.
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Sources
- NHS — Immune thrombocytopenia (ITP)
- National Heart, Lung, and Blood Institute — Immune Thrombocytopenia (ITP)
- American Society of Hematology — Clinical practice guidelines
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
ITP Explained: Low Platelets Without CancerWhat ITP is, in plain wordsSteroids for ITP and Their Side EffectsWhat to expect if steroids are startedIVIG in ITP: When It Is UsedThe drip often used close to deliveryITP in Children: Usually Self-LimitingIf your baby's count stays low after birthITP and Low PlateletsThe full guide to ITP and low platelets
Talk to us
Pregnant and told your platelets are low?
Share your blood reports with us. CION's haematology team will go through them with you and work alongside your obstetrician. One helpline serves every CION centre.