ELCS with GA?

[Sushirolls]

Evening x

I was just wondering if anyone knows if it's possible to have an ELCS with a GA, rather than an epidural/spinal block?

My daughter has hydrocephalus and from what I've read, epidural etc is a no no due to this. My daughter is also extremely needle phobic so wouldn't tolerate it anyway.

Obviously, we would hope that a natural birth is possible (I'm not sure how that works with hydro & we are also concerned about her pelvis being big enough as she was prem & has always been dinky) but if there was any risk of an emergency CS, my daughter would rather just book one from the outset.

My daughter has an appt with a fetal medicine consultant tomorrow and we will be asking lots of questions, but I thought I'd ask here for advice too.

TIA x

Yes it is possible. Not sure what criteria they apply but it definitely is done.

Very unlikely I'm afraid. She would still need a needle to have the GA. Sorry. Have you spoke to the midwife etc to see if they can put extra support in place?

Sorry, just saw she can't have an epidural. In that case they may need to do one- it's something you really need to discuss with the consultant. Good luck. X

Thank you for your replies x

In the past, they've used the mask (sedation?) to start with and as she's going, they do the canula & GA.

We are going to ask everything tomorrow, but thought I'd ask here if anyone had any experience. I'm a bit apprehensive as I think she will be having another scan to check baby (she's coming up 16 weeks). Crossing everything that baby is ok xo

**for past procedures (she hasn't been pregnant before) x

You need to be guided by the anaesthetist. The fetal medicine consultant is unlikely to know the answers and will want to refer you to the anaesthetist who will decide if an epidural is possible. I’ve certainly seen a woman with hydrocephalus have an epidural (not a spinal) for an elective section.

General anaesthetics are higher risk to the baby so will be avoided if possible.

Unfortunately, my daughter is extremely needle phobic and wouldn't tolerate an epidural anyway 😢

We are going to ask if it's possible to be referred for desensitisation again, or hypnosis. Hopefully, she will also be referred to an anaesthetist. She also has a history of epilepsy and just been dx with Vasovagal syncope.

We'd just like something put in place incase of an emergency x

I've got grudging agreement that I can have one in June. They aren't happy about it and I have to go back to talk to a senior anesthetist to make sure there is nothing they could do to make me consent to a spinal but it's down in black and white on my notes.

There are no underlying physical health reasons for it, I have a back which someone managed to get an epidural in last time so there are no concerns about a spinal but given the circumstances of ds's arrival, my mental health and how I view surgery in general, c-sections in particular, being awake is never going to be a positive experience for me.

The consultant obstetrician referred me to the anesthesia clinic as they had the final say. They went over the risks (although they said the risks were primarily to me not the baby) and that I'd obviously miss out on seeing the baby when they are born and a whole other bunch of bonding woo stuff but when I explained my reasons, they agreed on the proviso that we would revisit the discussion with a senior consultant in a few weeks, at the pre-op with whoever was running the clinic and the morning of the surgery.

So yes, I'd say it's possible but that there might be resistance depending on the circumstances.

Thank you so much @Dinosauratemydaffodils 😊

My daughter has tried desensitisation therapy in the past which they gave up on and she's missed all bloods so far because of it. I'm hoping we can try again or try hypnosis to try and get past her phobia, but if I'm honest, I'm not hopeful (I haven't said that to her though), she has such a strong fight or flight reaction. We have tried to get past it for years, and as a child, they'd just knock her out with GA (she has an extensive medical history). I'm hoping that they'll understand her reasons and that she isn't just trying to be "difficult", as she's not.

Good luck to you, I look forward to hearing your baby news xo

Really hope it all goes well for her.

Well they won’t want to do any sort of lscs without her having had bloods prior to surgery. Really hope they can sort some therapy out for her so she can manage some blood tests.

I'm an anaesthetist. She needs to see an anaesthetist - hopefully her midwife or consultant will refer her soon. ELCS under GA is certainly possible but a gas induction (using the mask to send you to sleep) really isn't safe in late pregnancy; she will need to have a cannula beforehand, though can ask for EMLA cream to numb her hand. She will probably also need to have some blood tests done prior to the day of surgery if she does decide to go for a CS.

Definitely some kind of therapy, whether it's desensitisation, hypnotherapy or something else, would be helpful for her.

Thank you everyone, for your help & advice I appreciate it x

Fingers crossed, desensitisation will work this time, or hypnosis - if they'll refer her & it can be done in time?!

A mother's worry never stops does it!!?! Even though my "baby" is having her own baby, I'm still worrying lol x

Hope her appointment goes well today.

I was worried they would think I was just being difficult/weird too but if they did, they managed to hide it well.

Thank you