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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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Original poster

to wonder why bigger ladies in pregnancy need stockings?

71 replies

cbeebiesinducedcoma · 18/09/2012 21:03

I am a bigger BMI , but I was last time and had a very straightforward pregnancy and birth and did have a big baby (9'3) but I was 9lbs myself so not too far out.

I had a consultant meeting and said lots had changed since I had first and mentioned having a special anesthetist appointment, stockings? and an injection after birth.

I have very painful SPD which affects my mobility but other than that I'm okay really had very severe MS but tapered off.
Consultant was nice saying 'we don't want to change you its just to help' which is fair enough.
AIBU to think this is a bit OTT? if their are no other issues.

OP posts:

minipie · 19/09/2012 14:38

3littlefrogs is having stiff calves in the morning a sign of DVT? (I am 28 weeks pregnant, normal BMI and keep getting this).

apols for hijack

3littlefrogs · 19/09/2012 14:48

Hi minipie

It sounds as if what you have is more like cramp. It would be unusual to be unlucky enough to get DVT in both legs.

Things to watch out for are pain, tenderness, redness and swelling. Also look for pitting when you press the skin in front of the shin bone. (puffy legs and ankles do occur in pregnancy, but if it is one leg plus the other signs you need to get it checked urgently). The other thing to look for is any sign of distended veins in the lower leg and foot. Compare with the other side. If necessary get a tape measure and measure round each calf.

Chest pain and/or cough, especially if coughing up blood, either with or without calf swelling is a big danger sign.

Some hospitals are still not following the measures mentioned in this thread. These hospitals will lose out financially because some funding is being witheld if they do not conform. However, it is up to the Trusts to put measures in place, hopefully they will get on and do it once the financial implications sink in.

Thumbwitch · 19/09/2012 14:49

minipie - are they swollen at all? are you feet or ankles swollen? Is there any heat or pain in the calf as well? It's not likely that you'd have a DVT in both calves at the same time, to be fair - it's probably the more normal cramp that is also v. common in pregnancy - but if you're really worried there is an extremely simple blood test that can be done to check for clots, ask your GP or your MW.

I see now that the OP is offended because she thinks that this has only been offered her because of her weight. Well it might have been - because increased weight increases risk.

Thumbwitch · 19/09/2012 14:50

xposted with 3littlefrogs.

JustFabulous · 19/09/2012 14:51

Maybe they didn't use them in the past as they hadn't realised the benefit of them but now medicine has progressed...

Bosgrove · 19/09/2012 14:51

I have a high BMI and have had three pregnancies. The injection is probably clexane which is a medication which prevents blood clots, people often get 40mg after a CS. The dose that I am on throughout pregancy (I am prone to Blood Clots) is 1 mg per kg of body weight twice a day. The injection can be painless, I usually inject in my bottom and do it myself. Before I learnt how to do it a nurse did it in my stomach, and if she was a bit rough it could sting and bruise a bit.

The stockings are also to prevent DVT's (but I don't wear mine, I have been advised my my haemotologist not to wear knee length ones which are all they have in our local maternity department)

Also in my last two pregnancy I have been referred to see an anaesthetist, it was a bit of a waste of time, but I think they wanted to cover the risks of an epidiual while I wasn't in pain.

I have also had to have GTT to check for diabetics in all of the pregancies despite not having sugar in my urine sample, again I think it is just ticking boxes in my maternity records.

3littlefrogs · 19/09/2012 14:54

Trickle - it is a huge issue. The mortality and morbidity is staggering and the cost to society is incalculable.

10 years ago it was estimated that deaths from hospital acquired VTE (Venous thromboembolism) amounted to more in total than all the deaths from breast cancer, HIV and RTAs put together.

Someone likened it to a jumbo jet crashing every 3 weeks (I think - I would have to look it up to see if it was 3 weeks or 10 days).

It just isn't a particularly newsworthy condition so didn't really get the recognition that other, more well known conditions get.

Bosgrove · 19/09/2012 15:01

Having just seen the last few messages, I have had a couple of DVT's over the years. My leg swelled in the first DVT (not in the second we found the clot earlier) and it felt like I was walking with a welly boot filled with water. I also found it hard to walk even short distances without wanting a rest.

But if in doubt get it checked out. It is just a Ultra Sound scan which will show one way or the other so nothing scary. I am lucky enough to have Protein S Deficency which only 1 in 20,000 people have, so as soon as I felt the symptons again I got scanned before my leg swelled the second time.

minipie · 19/09/2012 15:02

Many thanks 3little and Thumb - it is both legs, and no swelling or pain or chest pain so likely just cramp (feel a bit now!)

Thumbwitch · 19/09/2012 15:15

No no minipie - never feel about it! My dad has just today been sent to A&E by his GP because he had a swollen foot - no pain, no heat, just swollen. And bingo - a 3rd DVT, but this time with no real reason (apart from the fact that he, like me, has Factor V Leiden thrombophilia).
It's ALWAYS better to be safe than sorry - my uncle died from an undiagnosed PE because we didn't know before then that this condition was in our family.

3littlefrogs · 19/09/2012 17:04

Thumbwitch - is your dad on longterm anticoagulation? I hope he gets sorted out promptly. Poor man, having 3 DVTs.

Thumbwitch · 19/09/2012 17:07

No, but I think he may be put on it after this. The first 2 were quite understandable - one after a flight and the other after an operation - and he was on warfarin for about 3m after each of those, as well as on Clexane or Fragmin in the hospital - but each time they stopped it. As I say, this one has come out of the blue, no obvious risk factors that I know about and he wears flipping flight socks every day to try and avoid this happening, so I'm thinking they'll go to long-term anti-coag. It's been a while since the last one - a few years.

3littlefrogs · 19/09/2012 17:12

Hmm - after a second clot in a patient with factor V Leiden I would expect them to be on life long anticoagulation. I hope he has a good haematologist looking after him. Hope he gets better soon.

Thumbwitch · 19/09/2012 17:15

Dunno - I've not met the haematologist and I'm a bit dubious about the hospital he goes to - they're a bit, um, hit-and-miss with some things, in our experience. Luckily though, he has a VERY good GP. :) I'm pretty sure this will be ratpoison for life now.

katykuns · 19/09/2012 17:25

I felt like this too OP, as had my first DD in 2006, and didn't have any of it. Then had my DD in May this year and was given them after the labour and the injections and felt a bit overwhelmed.. had no clue what they were about.

My DP did all the injections, but I didn't wear the stockings, as they kept rolling down and leaving massive dents in my skin. My midwife agreed that it was probably not worth wearing them as cutting off the circulation was likely to be more harmful!

I found the anaesthetist's appointment hard going as he just saw me as a fat liability, and made me feel like I was such a burden :(

kate2boysandabump · 19/09/2012 17:44

It's not just about having a high BMI, there are other risk factors too. When I booked in with the midwife I got 0.5 for having a BMI over 30, 0.5 for being over 35, but 1 for having a relative, my mom, who'd had a blood clot. That wasn't enough to have to have the injections. However, when they reasses me after the birth, if that's changed, I'll be happy to take whatever they give me. Having seen my Mom be so ill, I'll take a bit of discomfort over having a stroke.

Softlysoftly · 19/09/2012 17:49

Never heard of them for just BMI or the injection, I have a high BMI and DD2 is 3months. I would have turned down any extra injections as have had no issues caused by BMI in either pg.

Only heard of stockings for C-Section?

3littlefrogs · 19/09/2012 17:59

The reason that Thromboembolism is no longer the leading cause of maternal death in England is because of the introduction of these new measures to risk assess all pregnant women and give appropriate thromboprophylaxis to those who need it. (eg stockings, injections).

There are many risk factors including (but not limited to):
Age
multiple pregnancy
family history
previous clot
BMI
smoking
thrombophilia
number of pregnancies

Pregnancy is a hypercoagulable state - so one or more of the other risk factors in addition to being pregnancy represents a degree of risk.

Surely it is a good thing to risk assess and give preventative treatment???

Just because these measures were not implemented in recent years does not mean that it is not necessary to implement them now.

3littlefrogs · 19/09/2012 18:03

Being Pregnant. Not "being pregnancy".

MammaTJisWearingGold · 19/09/2012 23:58

Another one is the test for gestational diabetes. I had the test with DD2, but with DS, I told them that I know the signs and symptoms of diabetes and I know my own body, so I would not be starving myself and my baby for hours and then drinking the disgusting drink, thank you very much. I was surprised by how little I had to argue my case.

Thumbwitch · 20/09/2012 00:35

They can't force you to do the test if you don't want to, MammaTJ.
I've done the GTT 3 times this pg, not once last pg. I don't care - I'm a high risk for it so I've done the test - I'd rather do unnecessary tests than risk any harm.
GD is often missed because it doesn't always present the same as normal diabetes and often the symptoms are ones you would have in pregnancy anyway. It's missed enough that in Australia they now routinely do a GTT on all pg women at 28w, regardless. Don't know about the UK now.

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