Very dubious about consultants advice to take low dose asprin

[5ChildrenAndIt]

Given that I've haemorrhaged after delivering each of my 4 babies - and generally I am prone to bruising/bleeding. My clotting was tested after DC1 - and described as 'just the right side of having van Willebrands disease' (a v. Mild version of haemophilia).

Apparently it reduces the incidence of pre-eclampsia (which I've never had - but I have had pregnancy hypertension in every pregnancy) - and I am advised to take a daily low dose 12 weeks to 32 weeks.

hi this is my first pregnancy, like you I also suffer from hypertension, always have, I have been prescribed asprin too and have been medicated by an obstetrician for tablets to reduce blood pressure too. seems standard practise to me

Hi, I've been prescribed aspirin too, although for different reasons. I never even took the prescription in. If you don't want to take it then don't.

Have you told your consultant about your clotting issues and have they still advised aspirin? I know it is commonly recommended in pregnancy, for example I think pretty much as standard for those having IVF treatment (it was for me), but it may be that with your medical history it would not be recommended. Anything medical is a balance of risks and benefits.

She came in with the asprin very early in the consultation. I then mentioned the clotting issue - she seemed slightly thrown - and said "OK - take it until 32 weeks not 36 weeks - then it won't affect you for delivery". I'm not sure that really resolves the issue - but I didn't push it at the time.

I said I would think about it - and she seemed happy to move on.

Hmm it's usually prescribed for APS (the opposite to what you have)! I would ask for a 2nd opinion, just to reassure yourself.

I am in the process of being referred to haematology for von willebrands and I've been advised not to take aspirin or ibuprofen ever. I had a hysterectomy in 2012 where I haemorrhaged and lost 2 litres of blood and 3 weeks ago I had my ovaries removed and ended up in ICU as I lost 2.9 litres and effectively died at one point. I would definitely get a second opinion, as this cannot be taken lightly!!

Hello, hypertension in pregnancy is a risk factor for pre-eclampsia and NICE guidelines thereofore state that women with hypertension should take low dose aspirin from 12 weeks until delivery as this has been shown to reduce that risk. However, specialist advice should be sought for women with thrombophilia-can you ask for a second opinion from an obstetrician who specialises in this? Or from a haematologist? Did you have aspirin in your previous pregnancies?

I thought hypertension was 'co-morbidity' with pre-eclampsia (ie it is an early warning sign for pre-eclampsia but it doesn't cause it).

While I've been hypertensive - it's never got higher than a few points past 140/90 - and only reaching that at 40 weeks. Never had protein in urine or any other pre-eclampsia symptoms.

Technically I don't have a van Willebrands diagnosis - but the doctor described it as 'one notch away' - and I have bled heavily after every delivery.

I took asprin in my last trimester and when I had my c section I bled very heavily. Dh said when he saw how much I bled he said he wish I hadn't taken it. I would definitely get a second opinion.

You need a proper consultation with a haematologist who specialises in clotting. They are usually very experienced at dealing with bleeding/clotting in obstetrics. Your obstetrician should ask for a joint consultation. Many hospitals have joint clinics.

Hi 5Children risk factor doesn't neccessarily mean cause, it just means the two have been linked.

Wouldn't they think I was a nutter if I came in demanding a haematologist appointment to arbtrate a dispute about aspirin?

The consultant left it with a more polite phrasing of "take the aspirin, don't take the asprin - whatever - I've done my job by advising you"

If you need more help to weigh up your personal risks/benefits then I think its okay to ask for that.

5children that's a shocking attitude from the consultant. I think you're being very generous in describing it as polite.

There was a student in the room - which I think provoked a more 'grandstanding' attitude .

Fundamentally I think she was regurgitating standard advice - was a bit thrown by the blood clotting comment - but thought that it wouldn't make any difference at the low dose, stopping before 32/36 weeks.