After meeting with the chief of Obstetrics at Stanford several weeks ago, Nolan and I are having some blood work done. Mine was taken on Friday, and Nolan's will be drawn today. Both are being sent to a lab in Wisconsin which specializes in Neonatal Alloimmune Thrombocytopenia (NAIT), and in a couple of weeks we should have the final piece of the puzzle so to speak. This test will tell us whether we have a 100% chance of this happening with future pregnancies, or a 50% chance.
Best case scenario is obviously that we would have a 50/50 chance of our next baby being effected by NAIT. If this is the case, whenever I do get pregnant again I will have an amniocentesis at the beginning of the pregnancy which will determine whether or not the baby is effected. If the results show that the baby is thrombocytopenic, I will have IVIG (an immunoglobulin given over a 4-16 hour course through an IV) treatment once a week from 20 weeks on until the baby is born. At 32 weeks I would be given steroids to develop the baby's lungs, and then undergo PUBS testing. This is similar to an amnio except that instead of taking amniotic fluid, they would actually take blood from the umbilical cord. By doing this they can get the baby's exact platelet count, which will determine whether to be induced early, have c-section, etc. Because this is very invasive to the baby, there is a moderate risk of early labor (which is why they give the steroids). Most likely I would not be allowed to carry the baby past 36 weeks because the platelet count for whatever reason tends to drop faster in the last few weeks of pregnancy.
To put things in perspective:
Babies that test with a count of 50,000 and below are delivered by c-section in order to avoid head trauma and hemorrhaging. Jax was born with a count of 63,000. Each subsequent pregnancy will be more severe because my body will recognize the foreign antigens in the baby faster and fight it harder, just like it would a virus the second time I had it. Believe it or not, 63,000 is not considered severe. We are actually in the "safest" category we can be in, and with treatment we have an excellent chance of having a normal healthy baby next time around (somewhere in the 90% range). The goal (obviously) is to get the baby through the pregnancy and out of me without any hemorrhaging. Once the baby is out he/she will start to develop it's own antibodies and mine will die off (problem solved).
Hm, this was supposed to be a short blog. I got carried away!