Hematoma after c section

[tedster1022]

Hello mum’s,

I just had a c section on June 17th and unfortunately I’ve developed some complications, two large hematomas. I’ve been told by my OB and In the post partum unit that the hematoma will reabsorb but it’ll just take time. I was at the hospital for four nights. I was feeling fine until the fifth night when I started having extreme sharp pain on my left side of the abdomen which I never had during my hospital stay. Went back to emergency land pretty much they said to manage pain by taking stronger medications.
They do not suggest opening up and draining it as there will be risk of infection.

I’m having a tough time dealing with my current situation. It’s an elective C section as I had myomectomy done before along with few big fibroids. Delivering vaginally wasn’t really an option per my doctor. Feel like I've brought it upon myself and can't look after baby and family properly. I cry and I’m scared at the same time about my healing.

Has any mums here experienced this and is it true that the pain will get better as each day goes by and will take about 6 weeks? The area around my abdomen is all bruised up.

Sorry you’ve had this - hopefully someone can share more personal experience with you but I just wanted to say you haven’t done anything wrong, you didn’t bring it upon yourself, you may well have a wee dose of the blues combined with the complication making you feel very low! Ask for help if you can (and take what’s offered) - CS or no CS the first week or two can be very tough going!
It will take time and 6 weeks is probably a reasonable estimate (could be less but could be more) - make sure you’re having regular pain relief and taking it as easy as you can. X

I'm not sure if it would have any effect at all on a haematoma per say, but ask your midwife about arnica. I had EXTENSIVE bruising nearly to my belly button from forceps and couldnt sit or lie back (or stand) from the pain. Arnica did help it clear up in a few days (for me). By 8 days postpartum, they had faded dramatically (started the arnica at 4 days pp).

I'm so sorry to hear what you're going through Tedster.

I too had a large haematoma following internal bleeding after my elective c-section with twins.

I'm obviously not in a position to comment on what is appropriate for you but I wanted to share my experience with you.

After several hours of being nil by mouth whilst the doctors decided what to do, the consultant decided that no operation was necessary to remove the excess blood. He flamboyantly then arranged for me to have breakfast...

However, the midwife who was with the consultant when he delivered this news was horrified by this decision. She took him to one side and, a few minutes later, after she'd spoken to him and he'd consulted a more senior colleague, he came back to me. Although it was six years ago, I still remember his words: "I've been thinking about this and what I'd advise if my wife, who is pregnant, was in your situation. I'd want her to have the operation to remove the haematoma. So, that's what I think we should do with you."

So, I had a general anaesthetic and they went back in via the c-section scar. It turned out I'd lost 4 litres of blood - which explained why my whole abdomen was so tender and uncomfortable. They got as much of the haematoma and blood out as possible and sewed me up with two drains to remove the rest. This was when my babies were four days old.

Afterwards, the consultant and a more senior obstetrician both emphatically said that operating was the right thing to have done and that, actually, they should have done it sooner. What's more, they said that a haematoma can be an infection risk if left.

I went home when my babies were eight days old. Everything healed up quickly and I felt fine within a couple of weeks. I can barely make out the scar now - it's so faint!

Have they established how much blood you've lost? Have you had a blood transfusion? I was given four units the day before I had the haematoma operation and that instantly made me feel much, much better.

If you're still in pain, I'd ask them why they think you've got new pain. I'd also ask them if your treatment would be any different if the hospitals were not dealing with the COVID crisis.

I'd also ask them whether it is true that a haematoma can become a site that is vulnerable to infection.

Have you been scanned so they can see what's going on in there? They did this in my case before operating.

Are you on any medication to thin your blood? The consultant who was treating me was completely unaware I'd been prescribed this (serious communication fail) and it's important that they're across the full picture of what's going on.

I really hope you have someone who can support you in any interactions with doctors as I imagine you are feeling pretty rough and not in the best position to be assertive.

I hope too that you feel better very soon and that you can start to enjoy your baby.

Finally, many congratulations.

I developed a hematoma after my csection and was given some really strong anti biotics to clear it and it worked.

Could you ask for some antibiotics?

Thank you for every mum who’s shared their experience. I actually went back to emergency shortly after discharge. In fact twice. I was sent home after my first visit , them telling me to manage it with pain killer and then for the second emerge, I was wheeled in by the ambulance. It was very scary as with covid, no visitor policy so my husband was not even able to go to the hospital with me. I was immediately put on morphine and antibiotics for about 12+ hours. The pain was excruciating and no word can describe it. My white blood count was so high at 2300.

At first the doctors think my infection could had been with my fibroids so that’s why the antibiotics didn’t work. Apparently antibiotics don’t go that deep into something (something I’ve learned). And then they cut open my wound a little hoping to release the hematoma. There were a lot of old blood clot but at the same time, there were apparently fresh blood coming out because my hemoglobin count dropped down to 50. That’s when they are sure I’m actively bleeding inside. I was immediately arranged to have four bags of transfusion. And similarly that was right before surgery as they needed my count to be high enough. At first the OB said if the fibroids are infected there’s a good chance I’ll need to perform hysterectomy. I was crying my eyeballs out along with possibly the baby blues. I signed the consent form and during the blood transfusion, the doctor decided to have a CT scan as he said going in blindly to find source if bleeding is not great idea. So he’s made the best decision provably Becuase he came in telling me it’s good news. Not sure what that meant at first. He said the bleeding is actually into my rectus muscle which is where people build their 6 packs. He said my uterus was not showing any signs of bleeding from the ct scan. So he asked the vascular surgeon to join him instead of a general surgeon even though vascular surgeons are general surgeons. The vascular surgeon said to remove it because like you say, it’s a site for infection. It has to be removed.

So they arranged for my surgery that night. They reopened my c section incision and removed all the hematoma that was underneath the skin first and then when they opened the second stitch , they drained all the hematoma blood clot. I forgot to ask him how much blood there was (will do that tomorrow). They then found the source of the bleed and tied off or stitched the vessel. I now also have a drainage on me to see if it’s still bleeding. The following morning after surgery, my blood count dropped a little again possibly due to the surgery as I had one unit of blood transfusion at that time. Added another two transfusions. In total for this c section, I’ve had 8 units of transfusion.

I feel better after the surgery but the abdomen is still sore to the touch. The doctors say it’s normal but I’m so afraid of that word now. The previous OB where I had deliver said it was normal but in fact with such a big hematoma, it really needed to be removed. And importantly they would have found out that I was actually still actively bleeding when I was discharged.

I’ve been scared as shit but I’m really hoping I’m at the end of the tunnel. And that light is coming through. This is only my first pregnancy

Gosh you’ve been through a lot. I also wanted to say I didn’t mean to minimise what you’re going through by suggesting it was just baby blues, this has been a very hard time for you obviously! More just wanted to make you see that it’s normal to be feeling low with all that you are going through. It does sound like things should turn a corner now - and please don’t expect the same thing will happen next pregnancy, it’s a fairly uncommon complication! Hope you continue to feel better. And congratulations on your new baby - you probably haven’t really been able to enjoy him/her properly yet but hopefully you have lots of support around while you recover now. Xx

@TenThousandSpoons0 , thank you and no trust me I did have baby blues. Being alone at the hospital is scary. I can’t really sleep either because for the past few days, I’ve been well one day and then the next day I look like a ghost with a. White face after loss blood. It’s around 2:00am right now and I want to turn on the lights to check my color but I’m so afraid. Right now even with a slight warm ness in my head/arms, I call the nurse in for a temperature check. every little thing I feel or sense that is not right is making me panicky and unsure if I’m indeed going down the right path.

I really hope as well I’m turning the corner.

Also as a side question , I have stopped breast pumping simply because I was in so much pain. I stopped right around the tjme when my breast were engorged and producing some milk. I’ve stopped since and it’s about three days now, will this affect milk production to stop completely? I’ve asked the nurse to see if I can get a breast pump here but also want to clear it with the doctor.

Ah I was going to ask about breastfeeding - pretty understandable that that’s been a challenge. Is your baby not staying with you? The break may mean it’s harder to get breastfeeding/expressing established but it’s not impossible, you need to ask them to arrange a lactation consultant or a good midwife to spend time helping you over the next couple of days. There is no way any doctor should be against that - you should find they’re encouraging if that’s what you want to do. It may just take a bit of perseverance to get the volumes up (which is where support from a lactation consultant is important). Have they not offered any support for this before now? Also if you’ve been unwell and in surgery it makes sense if your baby hasn’t been with you, but if you’re now in recovery mode they should be able to accommodate rooming in so you can do lots of skin to skin time to help. Caveat - not sure how covid restrictions would impact that. X

@TenThousandSpoons0 I was discharged from post partum at a different hospital and when I admitted it was emergency and then admitted into the surgical ward instead of mom and baby. So my baby is at home with daddy. Yesterday was again another rough night as my hemoglobin dropped and had another two transfusion. So a total of 10 blood units really. And then this morning my hemoglobin count is a bit stable and did not drop. Finally!!! I was crying when it dropped and crying when it was stable. It was such delightful music to my ears! I think I’m slowly recovering and O had asked the doctor about breast pumping and they said I should focus on recovery. Breast pumping isn’t a priority. So once I’m stable I should be able to see a lactation specialist. The hospital where I delivered was where the service was offered.

Hoping to get it back but it’ll be pump and dump. I’m not sure if I will need to be on antibiotics either. ;(

That’s good news that things are more stable :) I would push a bit harder about the breast feeding support to be honest, it should be a priority. Are you under general surgeons/gynaecology instead of obstetricians? Often on non-maternity wards they’re not great at this stuff. Absolutely makes sense to focus on recovery but if breastfeeding is important to you then the mt need to provide support.

Sorry posted too soon must provide support. Again not sure re Covid situation but your baby is only a few days/weeks old, they should absolutely be doing everything they can to help this. I’m only familiar with places that have both surgical and maternity wards within the same hospital and it’s typical there for the surgical ward nurses to ask a midwife to provide input every day or two at least. And for babies to room in particularly once mum is stable. Have you been seeing a midwife?
I don’t want to make you feel extra pressure about this but just give you a bit of extra support to ask again about this and not be brushed off. I’m surprised if an obstetric doctor has told you the expressing support can wait, I think often people who aren’t familiar with breastfeeding think it’s not important but it should be part of the whole package of care you’re getting. X

The OB was here and Becuase I’m in a different hospital and admission was not delivery and Labor, they won’t be able to send a lactiona specialist to see me. The doctor thinks the all sessions have been now converted online here.

@Spry thank you for sharing your story. It’s tremendous help as I had gone through something similar. They will be removing the drainage now but my hematoma is now I’m my abdominal wall so it’ll take months for it to heal and reabsorb. I wish it could go by faster.

I should be discharged tomorrow. :)