C Section with Obstetric Pulmonary Embolism (blood clots)

[PEhelpp]

Hi all,

During this pregnancy I have developed multiple pulmonary embolus and have been on blood thinning injections for a few months now.

I am due a c section next month but haven’t had my appointment to discuss my care plan with a consultant yet. Just wondering if anybody has any experience with c sections after this diagnosis?

Am I likely to be given a date earlier than 39 weeks? Am I likely to be considered ‘high risk’ and be the first one into theatre on the day of my c section?

Would be great to hear of some similar experiences.

it will depend on the details of your situation. Are you on high dose blood thinners, or already weaned down? As a rule of thumb, if you’re down to a low dose, CS is usually done at 39 weeks, and you just don’t take your dose on the morning of surgery. If you’re on a middling dose sometimes this would also be the way. Sometimes you’re transitioned to lowered doses or split doses in the lead up to delivery to allow this planning, if your team thinks it is safe. If you are on very high doses, and your team think it’s not safe at all for you to be off this dose for a long time, then most often your Cs would be a little earlier - say 38 weeks - and sometimes “bridging” arranged where your injections are changed to a heparin infusion the day before, then the infusion stopped only for the shortest time possible to do your operation, then started again.

ultimately you’ll have to wait for your team to come up with the detail - and they’ll maybe want you to meet with the anaesthetists as well to plan around whether you can have a spinal or not depending on anticoagulation.

it’s a pretty well trodden path, you’ll be absolutely fine :)

Thanks for your advice!
I’m on a high dose of 120mg per day.
I have been told that I will need to have my last injection 24 hours prior to my scheduled c section, and then will start them again either 12 or 24 hours after. Hopefully this means that once I’m booked in, the date and time remains pretty certain!

I’m really quite anxious about the risk of haemorrhage and the need for a transfusion!

The risk for bleeding is pretty low overall when the timings are managed. Even when people go into labour with recent high dose, most often it’s absolutely fine. Is your CS being done because of the clots/blood thinners or for a different reason?

I guess you don’t really need to answer me on that because again will be individual :) but worth also just having a good talk with yoir team about what would the plan be if you go into labour before your booked date - they should be able to ease any anxieties for you a bit.