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Dr. Andrew Rynne

Family Physician

Exp 18 years

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Developed POTS after c-section. Test showed mpv 6.5 and platelets 363. Should I be concerned?

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Practicing since : 1999
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Hi, I recently delivered a baby at 23 weeks gestation via c-section due to complications, I have now developed POTS. they did 2 CBC in the ER, everything was normal except my mpv was 6.5 and 6.9 at another point, my Platelets are 363 during both lab draws. should i be concerned? could this have to do with the healing proccess of my C-section?
Tue, 11 Dec 2012 in Women's Health
Answered by Dr. Timothy Raichle 3 hours later
Hello, I would be happy to help you with your question.

Please define what POTS is - is this 'postural tachycardia syndrome'?

Let me know!
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Follow-up: Developed POTS after c-section. Test showed mpv 6.5 and platelets 363. Should I be concerned? 1 hour later
Yes Postural tachycardia syndrome. THey ruled out the thyroid, and they are ruling out adrenal tumors such as pheochromocytomas. after that I am not sure what they are going to look for? do you think this is something that could go away over time . I dont get light headed, or dizzy anymore (I use to last week) they have me on lopressor 50mg BID , and klonopin 0.5mg BID. (klonopin for anxiety) as I lost my baby during the pregnancy. anyway so 2 questions I suppose. can POTS go away, if its stress induced/deconditioned? because I bled my entire pregnancy due to Partial Placental Abruption. and I was bed rest for a little over a month, and THEN i couldnt move around well for 1.5weeks post C-section THEN I lost my baby...2 weeks after I lsot my baby the POTS started. Right now they are also ruling out Celiac Disease.

so questions should i worry about the MPV result?
and do I have a chance that POTS will go away?
right now walking heart rate runs in the 110-120's and in the morning can shoot up to 145 :-(
standing heart rate between 90-100
sitting 70-80
no lightheadedness/dizziness/ just a small amount of fatigue, POTS was diagnosed thry the tilt table test. they have me on a 3gram sodium diet and atleasst 2 liters of fluid a day, with no changing in blood pressure.
Also I lost the baby 10/30/12. POTS started 1.5 weekish later. if that helps
Answered by Dr. Timothy Raichle 19 hours later
I am terribly sorry about the delay.

First of all, with regard to the MPV (mean platelet volume) it is hard to know what to make of the number without the reference range. In our lab, the normal range is 6.4-10.4. So, even taking into account differences in labs, I think that this number is probably normal and not relevant to your current situation.

I spent some time re-reviewing POTS and have trouble finding correlation with pregnancy or recent delivery. Based on what you are describing you certainly XXXXXXX criteria for this diagnosis, and your treatment has been totally appropriate. As far as the lopressor medication, this can help with symptoms in low doses (which you are on) but in higher doses it can make the symptoms worse.

The condition is more common in the elderly and in women. Any situation that involves volume depletion (such as bleeding associated with a delivery) could cause these symptoms, but it is hard to find clear information on how it behaves over time. Given the clear association with your unfortunate delivery and chronic bleeding from the abruption during pregnancy, I can only imagine that this will improve as your health improves as you get further from delivery - especially given that it was not a problem before delivery.

You did not mention how long ago, exactly, that you delivered - how long ago was that?
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Follow-up: Developed POTS after c-section. Test showed mpv 6.5 and platelets 363. Should I be concerned? 48 minutes later
I deleivered October 23 2012
Answered by Dr. Timothy Raichle 9 hours later
Thank you for that followup information.

In answer to your original question, I think that the labs are of little to no concern and it would be appropriate to repeat them in the next month.

With regard to my last comments above, my prediction is that your symptoms will improve over time.

One thing to have them consider is something called Sheehan's syndrome. This is a condition related to excess blood loss and low blood pressure during delivery that affects the pituitary gland. You can look this up and ask your doctors about it.

I hope that this helps. Good luck!
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