Anaesthetist appointment prior to c section

[LeSquigh]

I have a c section in a few weeks to due to problems with my placenta. I have an appointment to see the anaesthetist a week beforehand. What happens at this appointment? I have already done consent forms etc...

The anesthesiologist will tell you about the risks of anesthesia, explain the process, evaluate your blood test results (your platelets levels - to ensure you can have spinal anesthesia) and your air passages in case you might need general anesthesia. That's it more or less.

Thank you. Due to placenta praevia I already know I will probably bleed more and I am already anaemic. Are they likely to do it normally?

Most placenta praevias are done under a spinal anaesthetic, unless there are concerns that your placenta has grown through a previous caesarean scar. Sometimes they might put two cannulae (needles in the back of the hand) rather than one if they are worried about bleeding. If you are very anaemic, they may want to transfuse you beforehand but this is unusual. Some hospitals have cell salvage machines, which suck up your spilled blood, wash it and give it back to you, to avoid the need for a transfusion.

Thank you. I've not had a previous section but I have had a previous retained placenta and manual removal (d&c I think). I do wonder whether this is related to scar tissue.

No, it's just where the pesky placenta decided to implant! Nothing to blame yourself for, plenty of first time mothers have placenta praevia too. By the way, if it is a posterior placenta praevia you probably won't bleed more than any other caesarean. Anterior placenta praevia bleeds more but still completely manageable (obstetric anaesthetist).

It is more posterior I believe. I am having the section at 39+1 which is later than I expected it would be. I have already had two bleeds and been admitted twice. I am worried I will go into labour and not get to the hospital in time and bleed. Other ladies I have spoken to who have had to have sections have generally been earlier but my consultant is refusing to bring it forward even by a few days. Is leaving it this late standard? I bled a lot last time and have suffered a lot because of it (PTSD).

Both times they had a prod at my (sweaty - summer babies) back too - just to check everything seems normal and they're not in for nasty surprises trying to do a spinal.

I like anaesthetists. Every one I've encountered has been both incredibly sensible, and just a little bit mad.

I think so, 39 weeks is standard for an elective section these days, before that you would need steroid injections to help mature the baby's lungs, so I guess they want to try and get you that far. Some women with PP end up staying in hospital towards the end of pregnancy in case they bleed, maybe that is an option if you're concerned.

Yeah I have had the steroid injections already, after the second bleed. I have been offered to stay in hospital but I would rather not - 1 night is bad enough! I'm not too far from hospital. I just presumed they would do it earlier and not take the risk.

Thank you for your help, it is much appreciated

I didn't realise this was a thing?

Had an ELCS for my LO and the only pre-birth "meeting" was when they spoke to me for 5 mins on the ward a few hours before I went down for CS

It depends on the hospital.