C Section With General Anesthetic??? Severe placenta Previa

[magnolia1]

Been o see the consultant oday. Now 34 weeks and have Placenta Previa Major which basically means lacenta is still directly over the cervix and in the way for normal deivery and in quite a bad place for a c section.
Consultant said they would prefer me to have a general raher than a spinal as it's a high risk c section. A general would mean obviously I would be asleep and Dh would not be allowed in the room.
I said no, I want spinal but if it went pear shaped I would allow a general. Dh shitting himself now I have another 4 weeks of worrying about bleeding let alone the thought of heamorraging during delivery.
Anyone had a section with severe placenta previa??
Anyone had c section with a general??

Magnolia, if the worse comes to the worse and you end up having a general, if wont necesscarily affect your ability to bond with your baby.
I have had a ga with my firstborn, he was born at 8.30am, and apart from holding him briefly as I was wheeled up to the ward, I didn't get to hold him again till about ten at night, as he was in the neonatal unit.
It was all pretty awful, not least because dh went with him, so I was on my own in recovery.
But as soon as I held him, it was fine, and I breast fed him as well, if you are worried about that.
With the twins, I had a massive heomorage (sp), and was really out of it, but continued to breast feed and bond, and managed to do this, after being taken back to surgery and given a ga.
The only point to me telling you all this, is that I hope you manage to have your baby under local, but if not, it doesn't mean that you will have trouble bonding. Hope that helps

But, could they not, if this worst case scenario would happen then give you a GA even though you have a spinal...sorry am jsut a bit ignorant about this!

Hi Magnolia. Try not to worry about the bonding and feeding.
I has severe pp and ended up with a crash-section under GA with ds when I started bleeding heavily. It was all a bit of a shock anddh didn't make it to the hospital in time but I woke up (or rather came round) to see dh giving ds his first feed. Not long after ds had his first breastfeed. I was a bit disappointed he was given formula but it never affected him taking to the breastfeeding. I am still going at 13months. It was also nice that dh had the opportunity to feed him since he'd missed the birth. I never had any trouble with the bonding either. I couldn't take my eyes of him and spend most of the night just looking at him. The midwives kept trying toget me to go to sleep but I just couldn't

They are not re scanning me. Have been told it can move but because it is totaly blocking at the moment it will not move out of the way completely so vaginal birth is out of he question. It also depends on whether the placenta is at the front or the back, mine is towards the front so more likely to be in the way when they try to get baby out.
Thanks ladies for listening, I guess I will just have to wait and see. Definately going to insist on Spinal though

Thats my main worry! No way are they going to formula feed my baby!! With dd4 they wanted to give her a bottle in scbu and Dh had to really fight to stop them
Luckily a lovely midwife helped me hand express and took it to them o feed her.

I had major previa with ds2.I had bleeding off and on for 3 weeks before they decided to deliver.
I asked for a spinal but was warned of the haemorrage risks and possible hystorectomy if complications occured.I had GA with dd and I was so out of it for days. I opted for spinal.
We were both fine, dh was there and held him first, it was lovely.. I hope this works well for you all.Good luck xx

I had placenta praevia twice (I'm not the same poster as below - she just has a similar name to me!) Both pps were grade 4 although I had no bleeding. Both were dignosed at the 32/34 week scans and I had elective sections at 37.5 weeks for both.

I was lucky in that my dh worked in theatres at my hospital at the time and we were able to get our 'dream team' of anaesthetist and consultant for both sections, in that the ones dh thought were absolutely the best in their field. I was told my placentas both times were in quite risky places but the consultant was confident he would be able to perform the ops under spinals, not generals. I was of course told that it could all go pear-shaped at any time and that a general was a possibility, as was a hysterectomy, but they have to tell you this because placenta praevia is a bit of an unpredictable condition and can be very dramatic if a bleed starts.

I had absolute confidence in my consultant (They call him 'God' at the hospital) so I was very happy to go along with what he said, and luckily for me he was happy to do a spinal.

If your consultant isn't happy with a spinal then maybe you need to go along with him, as he'll be the one doing the c-section. Some of them do tend to err on the side of caution. When has he booked the c-section for, or is it dependent on any bleeding? Are you going to be admitted soon?

Do ask any questions, I'm happy to try and help if I can.

I won't know who the consultant doing the c section will be. There are a few very good senior consultants at my hopsital so I know it will be a good one. The consultant today said it was up me but they would prefer a GA. Surely though I can refuse a GA? Its on 7th December if no bleeding beforehand.

Hi I haven't had PP, but had a crash c/s under GA with my last birth as it was cord prolapse. I had massive internal hemorrhage one hour after the op. I had further surgery and they sutured up some arteries or simelar and I didn't have a hysterectomy-that is usually the last resort even after a severe hemorrhage. I recieved blood and was in HDU for 3 days but recovered fine. I am pg again now (4 yrs later) and terrified of another hemorrhage. I believe there is medication they will give you/have blood ready etc and you will be monitored VERY closely, I think most dire situations are unexpected/unmonitored.

Magnolia, do try not to worry too much.
I had undiagnosed pp. Woke up one morning with wet feeling to find bed covered in blood. We dashed to hospital (one and a half hours away) and was told I'd have to have a caesarean.I begged for a spinal but the anaesthetist insisted on a ga. I then insisted that dh be allowed to watch, and even though it isn't usually allowed, they agreed that he could go up to the viewing gallery as long as he was accompanied by a nurse (in case he fainted).
Dh watched the section and then the nurse led him back to our room via the stairs. By the time they got there I was just being pushed off the lift with dd alongside. I was very groggy but with midwives and dh's help dd latched on for her first feed
It was so not the water birth I'd planned, but at the end of the day the birth is just one day out of the rest of your lives.
DD was fine, I was fine, and that's all that matters.
Good luck

I had dd2 under GA (crash section).I came round to see my best friend dressing her in the outfit I had chosen. It couldn't have been a better memory if I'd planned it.
I must have asked and been told that she was a girl when partially recovered, as I don't remember being told, but just Knew.
I had no problems bonding, and breast fed from the start.

She was taken out to my dp as soon as she was born, which was the next best thing for me.

If you do have a GA, make it clear that you are going to bf (he won't starve in the time it will take you to recover), and ask for him to go to dh, who can be ready to hold him skin to skin while you are looked after and come round.

Good luck, whatever you decide.

Thanks

I think then the consultants are just covering their backs. Of course you don't have to have a general unless it's directly putting yours or the bay's life in danger and, at this stage, it's not - it just has the potential to, and that's slightly different.

Both my sections were lovely, which kind-of made up for being in hosp for so long before I had them. We had our own music on, dh held them both first then I had a cuddle with them and after all the checks they let me have the babies next to me from then on. They were very positive experiences for us. I hope yours is as well. All the best x

or the baby's even !

You can definitely refuse. As I said earlier, I did have to insist, and I'm glad I did. The risk is real, of course, but by far most c-sections with pp go well. Mine was as complete as it could be - right slap bang over the os (and when they are there, they don't move at the end) - but the c-section went incredibly well and was a lovely experience - and I'd had a couple of bleeds as well. Please try not to worry too much.

You can definitely refuse. As I said earlier, I did have to insist, and I'm glad I did. The risk is real, of course, but by far most c-sections with pp go well. Mine was as complete as it could be - right slap bang over the os (and when they are there, they don't move at the end) - but the c-section went incredibly well and was a lovely experience - and I'd had a couple of bleeds as well. Please try not to worry too much.

I had an emerg cs at 34 weeks when I haemorrhaged with major placenta praevia. Woke up bleeding at 2am, went to hospital in ambulance. Hung around (on a bed in the delivery ward, being monitored, drip attached etc) till 4pm. They expected the bleeding to stop but I kept getting little gushes of blood every half hour or so. But ds was completely fine, so we kept waiting. Then I went into labour, so off I went to theatre. As I signed the consent form, they said it would have to be a general. To which I said, excellent, knock me out now (labour started rather fiercely). Dh says, on the way to theatre the surgeons and the anesthetists had an argument about whether I should have a spinal or a general, and the surgeons won. So I got into theatre and they were rolling me onto my side to do the spinal, with me thinking confusedly that they didn't do a general like that. Once it took effect I was glad to be awake.

The cs went fine, in spite of having to cut through the placenta and get it out in pieces. Ds came out yelling (i.e. breathing!).

Your question about bonding/feeding - I was awake but I only got to see ds briefly as they whisked him past on the way to NICU. Dh went to NICU with him and told everyone in sight that ds wasn't to have any formula. That was at 5pm and I didn't get taken up to see him till 11pm, when I got my first cuddle (it didn't seem like that long - felt like about 10 minutes). He spent a week in nicu and a week on the ward with me. We both came home when he was 2 weeks old, when he was fully breastfed (before that he had expressed milk down a nasal feeding tube). Bonding and feeding were not a problem!

Does the baby require you to be concious, to feed? Just a thought...

Make sure everyone knows the baby is not to have formula and give dh a printed "NO formula" sign to attach to the baby's cot!

Good luck! I thought that a haemorrhage / early cs was a worst-case scenario and actually it wasn't that bad. And you have a good chance of not bleeding.

Thanks fruitful xxxxx

Hm..have you been bleeding...thing is with placenta previa you will very likely bleed especailly at the end stage of pg...which is why it can be diagnosed without scans...however, if you don't have any bleeding there is a big likelyhood that the Placenta is not near your cervix anymore...think Mary Cronk has some Info in her wensite about this...

I had a scan today and the placenta is completely covering the cervix but I have had no bleeding. I don't think that not bleeding would mean they are wrong to be honest.

Had a CS under GA - totally unplanned but was a suspected placental abruption. The GA was given because my blood pressure was very low and apparently local anaesthetic can lower BP even further. I was under for about 45 mins, ds2 handed straight to dh and I woke with both beside me. ds handed straight to me and breastfed immediately. I had to say in bed for 24 hours but ds was in bed with me all that time, only taken out to get his nappy changed. Next day I was up and about as normal.

Good luck however it goes.

As I said before I had two grade 4 placenta praevia and no bleeding whatsoever, not even a spot.

They were both anterior as well (was trying to remember the proper term) which is like yours magnolia and why they think it is riskier.

No, lack of bleeding certainly doesn't mean they got it wrong. I had no bleeding until 36 weeks. Would never have known there was anything wrong if it wasn't for the scans

honeslty I have heard by mw and all that that bleeding will occur at some times of real placenta previa is there...sorry if I go tthat wrong!

magnolia1 - just to give you a professional perspective on this. Where there is placenta praevia that is anterior - the main problem is that the surgeon needs to cut though the placenta to get to the baby. When that happens there is can be massive bleeding. Where I work the anaesthetists are happy for spinal when the placenta is posterior but when it is anterior the prefernece is GA. With GA the abdominal muscles are much more relaxed and the surgeon is able to operate more freely. It means the operation can be done more speediy. If you have a spinal with massive bleeding you are going to feel the effects of tha. ayou will be aware of your blood pressure dropping and will feel pretty unwell.
There is nothing more frightening to a Dad than being asked to leave the theatre while his wife is put under GA. There is also a few minutes delay waiting for the GA to be effective which isn't very helpful.
If you are concerned about your baby being given formula, all you need to do is make sure your wishes are known. As a midwife I have assisted a baby (twins actually) to breastfeed while mum was still under the influence of anaesthetic. The Dad in question had ensured that the babies were put to the breast ASAP.
Where I work, where a mum has a GA, the baby is brought out of theatre to stay with Dad in recovery until mum comes through.
I would say listen to the professional advice - if the anaesthetist and consultant recommend GA it is based on clinical experience. Please do not think that because you have a GA you will not bond with, or be able to breastfeed your baby. Your DH can help with this and reinforce your wishes.
Also remember that there is a possibility that you may bleed before your planned C/S date in which case you would be likely to have GA. A spinal is not the best anaesthetic if you are actually beeeding beacuse a spinal makes the blood pressure fall and you would noty risk that with a woman who was already bleeding.
I don't want to frighten you but just wanteds to make you aware of why GA can be a preferable option as far as the docs are concerned.