DVT and pregnant but am I worried??

[Milly1707]

I am currently 18weeks pregnant with my second child and have been told by the midwife at my booking-in appointment that I have deep vein thrombosis. She said I had this during my first pregnancy (although no-one ever told me) and I would have to see a consultant during this one. I was so shocked that I was never told about this and that I had been receiving heparin injections during my labour and c section without being told. That aside I am being regularly checked and monitered and have blood tests every four weeks. Depite my inital shock, I am quite calm about this and know that I am being monitored closely. My husband, however, is another matter, he is convinced that becuase there is a problem with my blood that something is going to go wrong and he is panicking that something will happen to me or the baby. I am trying to reassure him that I am being kept a close eye on and it will be fine, but he just can't get his head round it.

What can I do to re-assure him??

[kitegirl]

Hi
your midwife's comments sound a bit weird - how come you had a DVT during your first pregnancy and no-one told you and how can she diagnose it now? From looking at old blood test results? Heparin injections are given routinely to everyone during c-section because of the clotting risk. If you have developed a DVT again during this pregnancy they probably spotted it from blood tests. When monitored, it can be managed. I had a pulmonary embolism (blood clot in my lung) last year and therefore I have to be on heparin (Clexane) injections throughout this pregnancy, are you taking the injections or are they just monitoring you through blood tests? Your blood thickens during pregnancy - nature's way of reducing risk of bleeding in labour, so that's why the risk of DVT increases but if the hospital is keeping a close eye on you, you and your baby will be fine. If you are on anticoagulants and under the care of a haematologist the risk of a clot is reduced to negligible. I would not leave it to the midwives to provide you with all the information, if you are worried you and your husband should go and talk to your doctor/consultant. Good luck with the pregnancy!

[Milly1707]

The DVT was on my first pregnancy records (she showed me when I queried this). I have an appointment with the Obstetric consultant and consultant haematologist on Monday to discuss the results of my last blood test and when I will need the Heparin injections.

I was a bit confused by the midwife so I am glad that I am seeing the consultant from now on, at least I can be surte he will know what he is talking about.

I am definately taking my husband to the appointment on Monday as both consultants will be there and he can ask all the questions he wants, I just hopes he calms down about it after that.

[yomellamoHelly]

Hi Milly1707!

Hope this isn't too larte in the day - have been on holiday so haven't logged onto mumsnet for a while.
Had a DVT when pg with nr 1 (no way I missed it - was a very painful experience). Then had another when ds was 18 months and am now pg with nr 2. Find it hard to believe you had a dvt without being informed/knowing.
Three months after ds was born I had to see a haematologist about the dvt and also what would happen in future pregnancies. Regardless of whether I'd had a 2nd dvt, though, I was told I would always (here at least) have been put on heparin from the moment I conceived - was told that I would need to check myself regularly once I was ttc. (Since the 2nd dvt I've been on anti-coagulants all the time.)
We went to see a consultant at St Thomas's who said that a dvt was no reason not to get pg, even though I have a susceptibility to having one (on top of being pregnant) - and that even if I did have another they're getting more and more practised at dealing with the consequences and therefore not to worrry overly.
So I know it's hard not to worry - but if the health professionals who deal with this kind of stuff day in and day out aren't too worried, themn you shouldn't be. I was told regardless of where I chose to have my next baby I would be dealt with "in conference" anyway, and I assume the same will happen with you.

Good Luck
H

[Milly1707]

I have seen both consultants and they have taken a load more blood. They are checking to see if my blood is too thick etc... and then decide on treatment.

The only thing I do know is that I have been told because I had such a long labour last time (34hours) and only got to 8cm I will be booked for a planned section this time so there is less risk to me during the birth.

Not quite sure how I feel about this as I felt crap for weeks after my first section!!!

[Pollyanna]

Hi Milly, I had a dvt during my first pregnancy. it seems very odd to me that you had one but weren't told. I knew I had mine (very painful) and had to inject heparin from then on. I then had to inject Clexane from week 24 in my subsequent pregnancies. I am also surprised they are saying you should have a c-section. Anti-coagulant drugs increase the risk of bleeding, and therefore c-sections (and even epidurals) are discouraged unless absolutely necessary.

There was nothing in my blood to suggest that I would have a dvt, or what the cause was.

If you did have a dvt, I agree with you - it is much better that you are monitored. the chance of getting another dvt is slightly higher in a second pregnancy (even when taking the drugs), but it is much better to be monitored than not. The consultant may give you some stockings to wear too to minimise the risk of a dvt re-occuring.

Sorry about the essay - hth!

[Bramshott]

Hi Milly1707. As a fellow (although like yomellohelly boy did I know about it!) DVT in 1st pregnancy sufferer, I must admit that I would query the advice re C-section. Surely major surgery carries a larger risk of a clotting incident than a vaginal birth? Can they not assess this later on?

I'm amazazed that they didn't tell you about your first DVT. Most people have to continue having blood thinning treatment after the birth so it's odd that they gave you heparin during labour and your c-section and then nothing thereafter.

We are about to start TTC No 2, and like yours, my DH is a bit worried. There's a really helpful factsheet on Thrombosis in Pregnancy at \link{http://www.thrombosis-charity.org.uk\this site}. As far as I can tell, the main risks of a DVT are in it not being diagnosed, so if you are already being monitored then that's all good.

Good luck!

[Milly1707]

Yeah, I have heard about these stockings, not sure what DH will think when he sees me like a pregnant Nora Batty!!!!

I am keeping fingers crossed that they say the results of the blood test are okay and I won't need treatment.

I am so confused over this whole issue, the first midwife just mentioned then DVT then didn't tell me anymore and this consultant was foreign so I had trouble understanding his accent. I don't know much about DVT but from what I have heard it is very unlikely that I could have made it through a entire pregnancy without knowing.

i just wish I could get hold of my notes or an easier to understand consultant and find out all the deatils. It's quite scary when you don't know all the facts!!!

[Bramshott]

Sorry, took too long on my post! Try the factsheet though, I found it really helpful.

[yomellamoHelly]

Was also told they'd avoid doing a caesaerean if at all possible because of the incereased risk of having another clot despite the medication.

The other thing worth noting is you may be delayed in being able to have an epidural, since you need to leave 12 hours from having your last dose (risk of paralysis apparently) - so it's worth investigating alternative forms of pain relief, and getting this on your notes if it's not hospital policy to offer what you'll require (save the hassle when you're not in the mood for an argument).