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Childbirth

Problems with cs and low blood pressure?

12 replies

Tolalola · 06/06/2011 18:42

I was advised to have an elective section after a previous emergency section.

I went into hospital on Thursday and was first on the list for Friday, but when I got to theatre they said my blood pressure was too low and they couldn't do it under spinal but could do a general. I refused a general as I had a terrible experience with the anaesthetic after my emcs and didn't even get to see my baby for 2 days.

We've been waiting since to see if my blood pressure would come up, but no luck. It seems that the only choices are to wait and hope that labour starts naturally (they won't induce because of previous section) or agree to the general.

Has anyone else been in this situation? I can't decide what to do - I'm feeling quite pressured by the medics into agreeing to the general but I really don't want to. Not sure what the likely risks and outcomes are of waiting...

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redundant · 06/06/2011 19:04

no advice I'm afraid but hope someone else will have. How low is your BP? And is it always low or has it dropped further? Mine is low too and i'm hoping for a 2nd c sec - hope it works out ok for you.

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Tolalola · 06/06/2011 22:16

It's always on the low side 90ish/70-80ish but is 80s/40s at the moment. The anaesthetist says he wouldn't want to do a spinal unless it was at least 90/70, but that's realistically just not going to happen...

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Snowsquonk · 07/06/2011 10:58

One of the side effects of spinals and epidurals is that they can cause lowering of blood pressure - so if yours is already low, doing something which they know might lower it further is probably too risky.

Sometimes blood pressure increases as a woman goes into labour, so you could wait for labour to start spontaneously and the see what your BP is and make a decision based on that - if the labour is going on well you want to avoid further surgery. What is the reason other than the previous section? Just having a previous section is not a good clinical reason for a second (unless that is what YOU want to do)

Ask for an appointment with the anesthetist and get them to explain things properly to you so you understand what the risks are of each option, then you can make a decision based on that information.

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Tolalola · 07/06/2011 15:51

Thanks so much snowsquonk. Yes the anaesthetist told me that spinal or epidural can lower bp by up to 40%, and that they wouldn't risk it. Mine's getting down into the 80s/30s when I'm on my left side at the moment.

I'm going to try to wait for labour to start spontaneously, but they've said that they won't induce and won't let me go past 40 weeks, so fingers crossed.

No real reason for telling me to have an elective other than that I am old (39) and that I had a section before. Was going to get tubal ligation at the same time, but that was a side issue, really. I'm not in the UK and they love to do sections here.

I took your advice and had a meeting with the anaesthetist - he said that he won't do a spinal unless my diastolic is over 70, and it's often not that high even under normal circumstances, so it looks like no chance. They don't do epidurals here at all due to the lack of post op care, apparently.

Current plan is to get a Bishop score and sweep on Friday and if that doesn't work to let them do ARM next Thursday with cs under a general on Friday if there's still nothing. Doctors have agreed but are totally flummoxed by my refusal to let them knock me out immediately!

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PrincessScrumpy · 07/06/2011 19:30

Now I'm concerned. My BP is 90/50 at the moment but has been lower during my pg. They haven't mentioned it being a concern at all - I'm having a cs at 37w for id twins. I'm going to have to ask at my next app.

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Maternelle · 07/06/2011 21:41

I am having my third C-S under GA next week because of low blood-pressure. Not in the UK either. My consultant got me to see a hear specialist and a neurologist and they felt it was the safest way.

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Tolalola · 07/06/2011 22:53

Yes I was also sent to a cardiologist to get checked Maternelle - I think they're so used to hypertension here (West Indies) that they don't really know what to do with low bp.

PrincessScrumpy, as far as I could acertain, the low pressure is only a worry if you want a spinal or epidural. They're ok with doing a cs under a general with low bp. The anaesthetist told me it's because the op is faster under a general?

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PrincessScrumpy · 08/06/2011 16:27

I really don't want a general as dh won't be ther and I won't be awake for dtds being born. Consultant's spoken about a spinal all the way through. I was planning to try bfing in the recovery room straight after.

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PeppaPigandGeorge · 08/06/2011 20:48

Just to say I had a GA and am still breastfeeding her, so it's not all doom and gloom if that's the way you have to go. You can specify you don't want a bottle given while you come round - babies are fine waiting for their first feed (unless there are specific problems).

I had an emergency CS under general, but had an elective with spinal first time round and my diastolic was 63, systolic in the high 80s!! Nobody even mentioned it as an issue!!

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nearlytherenow · 08/06/2011 21:56

I have low-ish blood pressure and have had 2 caesareans - one emergency and one planned. My reaction to the anaesthetic (spinal) for the emergency first time was awful, basically I vomited over theatre and then passed out. It took days before I felt well again.

For my elective, there was a discussion about spinal vs general, and I opted for a spinal (my BP isn't quite as low as yours - by the end of pregnancy it had come up to 90-100 over 60-ish). I was given loads of fluids in theatre (and for a good few hours afterwards), and some extra anti-sickness drugs through the IV. Can't say it was pleasant, I still felt dizzy and sick, but didn't actually pass out, and was able to cuddle and feed my baby afterwards. I felt fine after about 4 hours. I'm not sure though that a general would be much worse than this? I've never had a GA, but if your reaction to spinals is like mine, it won't be an experience you remember with much clarity anyway.

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PrincessScrumpy · 09/06/2011 16:59

MW told me today that they will just give me lots of fluids to increase my bp so I don't need to worry about GA.

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Tolalola · 09/06/2011 19:18

That's really good news Princess. They tried that with me but it didn't work. I've been drinking tons of disgusting rehydration stuff for days but no change - this morning's reading was 88/32. Ho hum.

Looks like another general coming my way. It was so awful last time, I feel like crying just thinking about it.