Could I bleed to death??

[CrazyDi]

I posted recently as i am quite badly anaemic and was worried to if it could affect labour...

Afterthat post, I was admitted to hospital and after tests have found out theres something wrong with my stomach which has caused me to get 'pernicious anaemia' which means b12 jabs for life now!! After my jab last week my mw took some blood and arranged for me to see a consultant to see if my hb level was ok. At my appointment on tuesday the consultant was concerned as after 2 weeks of jabs etc my haemaglobin has risen from 4.7 to 5.0 !!

He is now trying iron which hasn't worked previously and if by next week my hb isnt up i have to go in to hosp. for iv iron. The consultant was a bit vague answering my questions and basically said if my hb isnt up and I bleed heavy during labour then Im in trouble!!

I have bled really heavy with the other 2 kids and needed tranfusions each time, so as you can imagine im terrified now and wondered if anyone knew exactly what will happen in this situation... Is there a chance I can bleed TOO much during labour??

Oh...I am now 38 weeks so times running out!!

Any advice??

[kid]

There is no way of knowing what your labour is going to be like. At least they are aware of your problem and are taking steps to help. They would monitor you closely.

[zippy539]

No advice but bumping because I know how scary this is (big bleeder here too! )

[Nettee]

As Kid says they will monitor you really closely - probalby put in an IV cannuala when you arrive in labour and get some blood cross matched for you before there is a problem. If they are all prepared for the worst then they can act quickly if you do bleed. Ask your consultant what the plan is for labour and what he is concerned about - what does he mean "in trouble" and what would he do if this happened.

[edam]

CrazyDi, am looking something up for you, but in the meantime would say anaemia is not that uncommon but dying from it in labour is really, really, really rare. Found the stat that only one woman died from post-partum haemorrhage in the whole UK between 97-99 (most recent figs I can find). Hope that's reassuring.

[nikcola]

sorry to butt in but did you get my cat edam???

[edam]

Hi again

Royal College Obstetrics guidelines for managing women at risk of haemorrhage say:

• delivery should be in consultant -led unit with onsite blood bank
  -anaemia should be treated before the birth
  
• you should be in the care of a consultant obstetrician and a consultant anaesthetist for your delivery - they shouldn't just plan the delivery with you, they should be there when it happens
  
• if they decide that surgery is the best option
  they should put two cannulas in place beforehand and have four units of blood cross-matched.
  
  You might want to go through the list with your consultant and check they have all this in place (or whehter this has been updated, I know there's a more recent report but can't find it right now).
  
  Hope that helps.
  
  You might want to go through that list with your consultant, and ask what he/she thinks about risk of vaginal delivery v. caesarean - can't see this in Royal College document.

[edam]

Nikcola, sorry, have been having nightmare with ds ill repeatedly and then me catching one of his illnesses, so only just slowly catching up with emails (work ones coming first, sadly). Will get back to you! Sorry!

[nikcola]

thats ok just glad you got it xxxxxx

[uwila]

I'm not sure if you can do this here, but I wonder if it might be worth donating some of your own blood before hand so that they can have it available in case they need it. I know that in the states before you go in for surgery you can donate your own blood, which is of course the only truly perfect match if you need it.

Although at 38 weeks, I'm not sure how much time you have for this.

[mears]

CrazyDi - the hospital will be prepared incase you do bleed. That does mean having a cannula in your hand and having crossmatched blood available for you 'just in case'. Some women lose very little blood at delivery, others lose more. You will be observed closely. You cannot donate blood yourself as for one, you are too anaemic in the first place. Secondly, blood is pooled from more than one donor and it is the red cells that are used for tranfusion. Try not too worry, your birth will be well planned.

[CrazyDi]

Thanks for all your advice...just caught up on it all!!

I have to admit, I am petrified as the sytron is making me sick and I know my hb is still low, but maybe going in to hospital for iv iron is better anyway as at least they can keep an eye on me!!

I think that the consultants dont realise that by trying to 'not scare you' with all the facts sometimes has the opposite effect and scares you even more as you build them up in your head as something terrible!!

Suppose will just have to stop worrying and see what happens!!

[milward]

Best wishes Crazydi - hope it all goes well. At least your docs are aware of the situation & planning ahead.

[suzanneme]

Hb of 5 is really pretty low - basically they will probably want to give you a few units of blood to get your Hb up to around 10 to be safe for delivery. I don't think you're any more likely than anyone else to haemorrhage even if you have before, but you wouldn't have to lose much blood to have a problem if your Hb is only 5. Don't worry; as long as they are keeping tabs on it they will get your Hb up to safe levels, even if it means transfusing a few units. You can have a few units in labour if necessary too.

Good luck with it all.