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Placenta Abruption

(14 Posts)
junkfoodaddict Sat 19-Jul-14 20:14:42

I had a placenta abruption during an induction nearly 3 years ago. DS was in distress (heart rate <60, Apgar score was 6 on birth), I lost >1500ml of blood and resulted in an EMCS and during that my uterus tore slightly but I was told this would not affect my chances of conceiving/carrying again. Also DS was born A+ whereas I am B- and I didn't receive my anti-D until 5 days after his birth. Also I had GBS.

So here I am pregnant again. I was wondering was sort of care I would receive considering my past history. I am more concerned about the possibility that DC2 may be Rhesus + like DS and what effect this may have on the pregnancy due to the fact I received the anti-D 5 days after birth, not the reccommended 3 days.

Also, I am leaning heavily towards a C-Section considering what happened last time (the induction brought on a rare side effect which made my uterus contract violently - apparently!) than a VBAC. What is the likelihood of this?

Would be interested to hear from those who have had a placenta abruption as I haven't spoken to anyone who has been in the same position as me before.

StuntNun Sat 19-Jul-14 21:40:49

I had an EMCS due to abruption with my first, VBAC with my second, and another EMCS due to abruption with my third. In all honesty I would have to recommend that you go private if you can afford it somehow. I did not receive the care I needed from the NHS with my third delivery (November 2012). I went to A&E the evening before DS3 arrived because I felt very unwell and thought I was bleeding. I was sent home without any kind of scan or internal. The next morning I was definitely bleeding so phoned the hospital but they didn't want me to come in. I spoke to my mum, she works with a paediatric nurse who said that I should go into hospital. So I phoned the hospital and told them I was going in which they didn't mind as they had a bed available. Then I spent the next 12 hours on the labour ward having a few mild contractions and still bleeding. Eventually about 10 p.m. a consultant wandered over and also seemed disinterested in the bleeding but decided to do an ultrasound scan. What a surprise, the placenta was coming away and that's where the blood was coming from so I was rushed in for an EMCS under general anaesthetic 26 hours after I had first arrived at the hospital saying I was bleeding. I honestly can't understand why a woman with a history of abruption who is a week past her due date would have bleeding dismissed as not a concern.

Taura Sun 20-Jul-14 06:38:33

I don't know if the private sector do emergency work... Aren't they all a bit "we'll look afte you while everything's fine but if you are high risk then off to the NHS with you"?
I would talk to your midwife, lay out your concerns. I would have thought you might get put on a "high risk" consultant care pathway rather than a midwife-led one. It would mean you get seen by the high risk team at hospital rather than the normal jobbing midwives. (Who I am sure are still lovely though!)
A friend of mine is a high-risk team midwife and this does seem to be the sort of 2nd pregnancy they would keep an eye on.

StuntNun Sun 20-Jul-14 09:53:10

You may find you are a candidate for an ELCS which would alleviate several of your concerns. When do you see your consultant?

junkfoodaddict Sun 20-Jul-14 11:43:47

I am very early in my pregnancy. Booking in appointment in August. I will certainly discuss my concerns with the MW. I was surprised that on my form it had several complications listed - placenta praevia and acreata (sp?) listed as two of them but not abruption so I wrote it in the anenatal summary box.
I did tick the box about baby being small for dates as that is why I was induced in the first place.
3 years ago, I was diagnosed with a low lying placenta at 20 weeks and had another scan at 36 weeks. Instinct took over and I asked the sonographer if the baby was alright and she snapped at me telling me that is NOT what they were here for! But after an hour waiting to see the consultant, he actually said that the placenta had moved (good thing) but DS was showing signs of slow growth and I had half the amount of fluid I should have had so I was booked in for another scan at 37 weeks. When that scan came along, it was discovered that half the fluid I did have had gone (no idea where!) and that DS still hadn't grown or put weight on. They did a doppler on the placenta but said absolutely nothing about its health. They did another scan at 38 weeks and another at 39 weeks and then the following day I was induced. I think partly because I was 2 days away from my due date and it was New Year weekend, but still didn't expect everything to go wrong.

Going private is really not an option - live in Yorkshire and no funds to go private. I am 'hoping' that your experience Stuntnun is a one-off terrible experience of the hospital and NHS trust.

rosielea Sun 20-Jul-14 14:17:29

I had a placental abruption with DD1, she was born with apgars of 0,0,0 and took 28min of resuscitation before she had a pulse. She is profoundly disabled as a result. There was no question that i would have an elective c-sec with my second DD at 38weeks. That was very straight forward and now 24weeks pregnant with DD3 and already have a date for her delivery. I'm not sure if it is the on going obvious effects of the abruption but all midwives/doctors have taken it very seriously. I had monthly scans too mostly to check the blood flow to the placenta. I would stress to anyone involved the need for extra care.
I have no experience with rhesus +/- but again it is obviously something which needs proper attention. I would think you need to be under proper consultant care.

StuntNun Sun 20-Jul-14 15:26:12

That must have been terrifying Rosie. My DS1 also has special needs and I do wonder whether it was because of the abruption. His Agpars were 1 and then 9 though so he recovered quickly after the delivery but there's no way of knowing how long he went without oxygen. With DS3 they were able to test the cord blood so at least we know he wasn't deprived of oxygen.

rosielea Sun 20-Jul-14 17:25:58

Stuntnun yes it was the most terrifying and life changing experience, DD1 is nearly 5 so it's no longer raw to think about, just part of our story. The forums I'm part of for parents of children who had HIE (a lack of oxygen at birth) have many mums who had abruptions. I know in detail what happened because we have a negligence claim against the hospital involved. I really think I'd push for a section OP.

LunaticFringe Sun 20-Jul-14 17:33:31

I had a massive abruption with dd2. I am very lucky to be alive but dd2 died as a result. I lost more than 3.5 litres of blood.

With my next pg I was handled with kid gloves. Spent weeks on the ante natal ward and had an ELCS at 35 weeks. This was planned with my consultant at a 14 wk appt. Ds is fine.

PM me if you want info and the best of luck to you.

rosielea Sun 20-Jul-14 19:22:54

So sorry for your loss Lunatic xoxo

LunaticFringe Sun 20-Jul-14 19:34:14

Thank you Rosie. Dd2 should be about the same age as your dd1.

junkfoodaddict Sun 20-Jul-14 20:28:50

Lunatic - I am so sorry to hear your story. I can't bear to think what it is like to loose a child.
Thank you so much everyone for your words of wisdom. I am 'looking forward' to speaking to a MW regarding my past history and will definitely push for a c-section. There is a part of me that would like to go for a VBAC but I know I would never be comfortable with the idea - especially as I live 40 minutes from the hospital and an induction is totally and utterly out of the question considering and I will be insisting that that is taken seriously and put in writing on my notes!!

StuntNun Sun 20-Jul-14 23:42:12

JunkFoodAddict after my first abruption I was offered an ELCS and after my second I was told an ELCS would be mandatory for any future pregnancies. So if that's what you would prefer then make that clear.

slithytove Sun 20-Jul-14 23:44:46

Is Yorkshire classed as the north west? Try contacting 121 midwives, private experience but NHS funded, and I can't praise them enough.

You will get community care along side them if you wish.

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