### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I was diagnosed with ITP In January 2009. I was told it was pregnancy related and my platelets would go back to normal after delivery. When I went to the er in January 2009 my platelet count was 1100. I had my child August 2 2009 and my platelets remained low. In November 2009 I had a bone marrow biopsy and it came back fine. In Dwcember 2009 I had my spleen removed. I still have low platelets to this day. I have been treated with dexamethasone, prednisone and IVIG treatment. Any suggestions?

### output:

Hello madam!you talked a lot about yourself but nothing about the baby. How is he. Has the baby got ITP? Any complication of ITP? I haunt seen any mother die from ITP during pregnancy so far but I have seen every 5th baby of ITP mother die of intracranial hemorrhages and bleeding. So I request you please no more babies. You will pose a threat to you and them both.  Plus avoid activities which result in trauma. If you plan further deliveries at least do it where level III NICU are available. Steroids won't be enough for you.(prednisone)you need platelet transfusions right after the dosages of Intravenous immune globulin (Jamnagar S/D, Grammar, Gamine, Carmine, Polygamy S/D) this will help reduce the lysis. Intravenous anti-D (Winch, Winch SD) have showed some promising results. Add some thrombotic agents to your diet(platelets producing stimulators) like proact(eltrombopag) and Plate (Romiplostim).I would strongly recommend seeing the hematologist in case thrombocytopenia persisted. Regards Chat Doctor. 