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

### input:
Hello I had a question. I m pregnant with my second baby. My first pregnancy I was diagnosed with having low blood plates. Throughout the pregnancy they went down further and further. When I went in for my induction they were at 60,000. I tried for a natural birth but ended up having to have a c section. They really didn t want to with risk of me bleeding a lot. But I ended up bleeding normal. Well I just went in the other week for my first appointment and they checked my blood and said that my blood plates are already down to 120,000. I know the normal is 150,000. So my question is if they end up being so low again s my risk really high again? Or since I bleed normal the last time I will do so again? And I m probably going to have to do another c section and I m scared. Could I try for a natural birth? Just curious. Thmks so much.

### output:

Hi, You probably have a condition called Gestational Thrombocytopenia. In this the platelets count comes down due to pregnancy, but after delivery it goes back to normal. So you need not worry about, and if counts are above 50,000 it is generally considered safe, with no extra risk of bleeding. But before we diagnose gestational thrombocytopenia, we need to rule out other causes of low platelets like pregnancy induced hypertension, immune thrombocytopenia which can affect the pregnancy. Do you have a high BP? Edema? Tendency to bleed more? With one previous cesarean you can definitely try for vaginal birth after CS. The chances of success are close to 75%. If you have gestational thrombocytopenia it is unlikely you will bleed in excess after delivery. But it would to be wise to deliver at a center where blood and platelets are readily available if required. Hope this helps. Regards.