Fragmin

[ivegotanemptyfeeling]

Has anyone given birth whilst on fragmin?

My daughter was taking 10 days worth of injections as she tested positive for COVID recently. (Precaution against blood clots.)

She's had about 7.

She was at hospital yesterday because she'd been having pains/contractions all the previous night. They recorded four in half an hour on the monitor. She was sent home: they said that they didn't know why she was getting pains.

A swab sample concluded that she had a very low chance of labour in the next two weeks.

She went to a midwife appointment this morning (coincidence) - a booked appointment that she had missed/rearranged whilst she was in isolation due to covid.

She's just been taken by ambulance to hospital after having pains every 10 min throughout the second consecutive night.

All I know, from a text message that didn't make sense, is that the head is in the birth canal?

I'm at my wits end - she had retained placenta with her previous two births.

I'm so cross that she didn't get the appropriate care yesterday.

Oh - she's almost 34 weeks.

Just extremely worried about the blood thinners/potential blood loss.

Any experiences?

All I can say is that she is now in the best place for dealing with any potential complications.

I've found antenatal care very hot and miss myself, but when it was all going wrong, they really stepped to and it was all hands on deck!!

Fingers crossed she's alright. She's in the best possible place.

Slightly different but my friend found out she has breast cancer around the time she got pregnant. Had a single mastectomy and was undergoing chemo. She gave birth last week at 33 weeks and baby is doing well at 5 pounds 6 ounces. Try not to worry all will be well ❤️❤️

Well - baby arrived at 1pm! Little boy (no further details.)

This is the hard part - mum (my daughter) is now waiting to go to theatre for removal of placenta (3rd time).

They tried to stop the contractions - but she had progressed quickly.

I'm so so worried (and crying) at the thought of potential blood loss because her last fragmin injection was 10.30 last night.

If the hospital had have said yesterday not to do the injection then that would've been better. But again, they assured her that there was very little chance of going into labour in the next two weeks.

I'm incandescent with rage that they put her at risk.

Hey didn't put her at increased risk though... the info they had said low chance of labour/ delivery in the next two weeks.

If she hadn't gone into labour, but stopped the injections, blood clots can be deadly.

You're 'in the moment', which I get, but this is no one's fault.

@physicskate

Hey didn't put her at increased risk though... the info they had said low chance of labour/ delivery in the next two weeks.

If she hadn't gone into labour, but stopped the injections, blood clots can be deadly.

You're 'in the moment', which I get, but this is no one's fault.

She told them Sunday that she felt as though she was in early labour - obviously prematurely.

She's had two previous births - are you suggesting she doesn't know her own body?

That happens far too frequently in my experience.

My feelings are valid.

I'm only 11 weeks pregnant but I am on daily fragmin due to a condition I developed. I've been told I will have to continue taking it throughout the duration of my pregnancy, so I don't see that there would be any concern about labour whilst on blood thinners. Many women have to take aspirin throughout also.

Your feelings are totally valid. I never said (or even implied) that they weren't. I also think there are two sides to every story.

The consequences of not taking fragmin could have been deadly. With the information about all the potential risks, a decision was made, which in hindsight was not the correct one for your daughter. Hindsight being 20/20 in all that means that incorrect decisions often don't become clear until after they're made. It wasn't that she received bad care, it's just that the information available pointed in directions that made the future difficult to predict.

I get being mad. But I also think you might be jumping to conclusions.

Living in your 'incandescent rage' bubble is fine as long as it doesn't undermine any future care that you daughter or grandson receive.

If you want people to blindly agree with you on everything and not try to put things in a tiny bit of perpective, mumsnet may not be the place.

This study might help assuage some of the rage: a meta-analysis of causes of pph.

www.healthcareimprovementscotland.org/idoc.ashx?docid=84ee51e6-d441-4dba-8ebf-4fa6a2857e0d&version=-1

Was doing some research on my own pph and it has a section on anticoagulants.

They won’t have just decided off the top of their heads that she wasn’t going to go into labour within the next two weeks. They’ll have done a specific swab which gave them result. There is a small margin of error for the swab and sadly her result fell into that margin of error.

So they spent all morning trying to stop her contractions? Why?

What a pity that they disregarded her completely the day before and failed to stop them before things went too far.

There's now a baby in NICU for the next three weeks - could have been avoided.

They did not listen to her concerns .... I find that outrageous.

And it's not the first time it's happened.

They were likely trying to stop labour because she wasn't even 34 weeks pregnant. Baby would need support (and now, unfortunately does). It's a shit situation. I really hope your daughter and grandson are alright in the end (now is not the end).

I do also think it's a shame she wasn't listened to, but the other signs that they use were not pointing at this being the likely outcome. It was unlikely, looking at the tests.

But medically, taking the fragmin was not likely to have effected what has happened in any way. It didn't lead to the retained placenta and isn't even considered an increased risk for pph.

I would much rather that you channel your anger and frustration here than letting your daughter gauge how upset you are. She will need the space to process her own feelings and decide what she wants to do about them.

So yes, be angry for your daughter that she wasn't listened to, but that isn't anything to do with the fragmin.

When she was prescribed fragmin she was told to cross her legs until it was out of her system. We took this to mean it would normally be stopped well within the due date.

She needed blood transfusions due to retained placenta twice previously.

The midwife at the surgery this morning said 'You didn't have the fragmin last night did you?' This is why the worry crept in. She was told on Sunday to complete the full course of fragmin because there was very low chance of labour in the next two weeks.

She's now had double the volume blood transfusion she had last time.

Her baby is in NICU for a long time. Her two other children 4yrs and 10mths will now have a very disrupted life for the duration.

It could have been avoided if they had taken her seriously. She had four contractions in the half hour she was on a monitor on Sunday. . That should also have been taken in consideration - also the fact that she has hEDS and gave birth early twice previously with precipitous labours.

But no one LISTENED.

Assuming she was on a prophylactic dose of fragmin it will have made very little difference to events today.

I'm on fragmin, have been everyday since I found out I was pregnant and will be until at least 2 weeks post partum. I am high risk pregnancy and high risk for csection but this does not change the fragment regime.

There is a misconception that it stops your blood clotting; this is untrue as that can be as serious as developing clots. It merely acts in a way that stops the formation of clots. That said in emergency situations there are blood products and drugs which can be given if someone fails to clot; imagine the hundreds of thousands of people of blood thinners, people end up with emergency surgery everyday for all sorts of reasons and survive with no problems.

It is very difficult at the moment for relatives as you aren't able to be as involved as normal and only get snippets of information. It seems from your post that they are both well and Grandson is going to be fine (congratulations by the way) even if he has a short NICU stay. It also seems as though regardless of what has happened in the last few hours your Daughter was at risk of retained placenta anyway and the team will have been aware of that plus she knows the drill so I'm sure is coping with it all.

Try not to worry and embrace the wonders of a new life.

So why ram her full of tablets and injections in order to try to halt the birth until they were sure it was out of her system?

Which didn't work by the way.

Huge blood loss.

She's just been seen by a senior member of staff to say that there will be an investigation carried out: to my knowledge no one has brought this up. Yet.

Clearly there's a lot more to this then can be covered here and you're clearly not going to get any answer from MN either. However I do hope you get what you need and that DD and DGS are well.

Was messaging with my daughter earlier.

She was saying that she was so glad that she'd had a midwife appointment booked for this morning because she'd have been too worried about ringing the hospital herself today.

Not a good situation to put a woman with a higher risk pregnancy in.

She had the impression that whilst in triage this morning she was still being dismissed as 'putting it on' despite contraction readings of 100%.

Then all of a sudden it became 'urgent' and the world and his wife descended on her.

She's just had another transfusion, her temperature has spiked and she's quite unwell.

Not good - don't justify the actions of professionals who don't listen. This should not happen. What if she hadn't have had an appointment this morning? She was certainly deterred from ringing triage again. They made her feel like she was being a nuisance - no one deserves to be 'treated' like that.

@ivegotanemptyfeeling how's mum and baby now? Hope all is well.x

@ivegotanemptyfeeling - I was in a similar situation to your DD, expect I was on a treatment dose of fragmin after having clots during pregnancy (so on a much higher dose that your daughter) and needed a section as I’d had two previously.

I was told at 36 weeks “labour isn’t imminent, you need to take the fragmin and go home” despite the fact that I was having mild contractions every 10 minutes (and having been in labour before, that is how mine always started!) The dr talked over me and would not listen to what I was telling her about my own body, even though I was saying clearly “I’ve been in labour before and I know what it feels like.”

I took the fragmin. Three hours later I was 6cm and had to have be rushed in for a general anaesthetic, had huge blood loss and my baby was taken to NICU. I’d been left to labour alone, without pain relief or continuous monitoring, because the dr refused to come back and see me even when I went back in, as she had decided I was not in labour. The midwives had to really fight to get anyone to come to examine me at all.

She put my life at risk and she also did it with an extremely cold and dismissive attitude (and it was that attitude I found hardest to forgive, any dr could make the wrong judgement call I suppose)

I wish so much that I had pushed for an investigation. The haematologist did come and apologise to me afterwards and say that he would never have let them take me to theatre if he was working, as the timing was far too dangerous (it was the weekend so he was not spiking) so I’d like to think there was an internal investigation afterwards.

I was too tired and traumatised at the time to take things any further though. I feel angry on your daughters behalf and it is good she has you to support her in getting this incident properly investigated.

How hard it to actually LISTEN to women who say they are in early labour, if they have experienced it before, and to make decisions taking that into account, rather than “well your cervix is closed”. The same with denying pain relief as “it is too early”.

[quote DixitWinner]@ivegotanemptyfeeling - I was in a similar situation to your DD, expect I was on a treatment dose of fragmin after having clots during pregnancy (so on a much higher dose that your daughter) and needed a section as I’d had two previously.

I was told at 36 weeks “labour isn’t imminent, you need to take the fragmin and go home” despite the fact that I was having mild contractions every 10 minutes (and having been in labour before, that is how mine always started!) The dr talked over me and would not listen to what I was telling her about my own body, even though I was saying clearly “I’ve been in labour before and I know what it feels like.”

I took the fragmin. Three hours later I was 6cm and had to have be rushed in for a general anaesthetic, had huge blood loss and my baby was taken to NICU. I’d been left to labour alone, without pain relief or continuous monitoring, because the dr refused to come back and see me even when I went back in, as she had decided I was not in labour. The midwives had to really fight to get anyone to come to examine me at all.

She put my life at risk and she also did it with an extremely cold and dismissive attitude (and it was that attitude I found hardest to forgive, any dr could make the wrong judgement call I suppose)

I wish so much that I had pushed for an investigation. The haematologist did come and apologise to me afterwards and say that he would never have let them take me to theatre if he was working, as the timing was far too dangerous (it was the weekend so he was not spiking) so I’d like to think there was an internal investigation afterwards.

I was too tired and traumatised at the time to take things any further though. I feel angry on your daughters behalf and it is good she has you to support her in getting this incident properly investigated.

How hard it to actually LISTEN to women who say they are in early labour, if they have experienced it before, and to make decisions taking that into account, rather than “well your cervix is closed”. The same with denying pain relief as “it is too early”.[/quote]

Exactly - they don't listen.

They completely put her off ringing back as her contractions continued all through the Sunday night. This is not acceptable. It lead to an emergency situation.

They were furiously trying to stop her contractions with various pills and potions because she'd had fragmin at 10.30pm the night before after having been told very low chance of labour despite regular contractions being recorded and the cervix being low. They said that they needed at least 24 hrs since the last injection before the birth. They had had all the previous day when she was being checked in triage to stop her contractions - and she should've been told not to have another injection. Surely the baby would have been better off being 'cooked' a little longer in any circumstances. She had had previous precipitous labours. She had massive blood loss due to retained placenta - there were complications during this procedure.

She had a further transfusion last Wednesday - her bloods are now low but sufficient. She was discharged on Friday. She was given a further 42 fragmin injections for home. She was told that it was due to recently having covid that she gave birth so prematurely. Baby has tested negative.

Baby is doing really well. He is very long and skinny. He is in upto 5lb clothes due to his length. He was dressed on Monday for the first time and will be moved to a cot today. He had his first breastfeed yesterday and will be having three breastfeeds today (3 hrly). Mum is having no problems with expressing for the tube feeds (her other son is just 10 months old).

Oh - and she was on the wrong dose of fragmin originally - a much higher dose than needed for her weight. She is now on the correct dose.

She has been regularly checked by midwives and doctors when she's been in the special care unit - she actually looks really ill. So the after care that she's had has been second to none.

Mum and baby will be fine. ☺️

Nana (me) was having kittens 😬

I think it could have been avoided with the correct treatment.

I will urge my daughter to seek some form of debriefing when this is over.

@ivegotanemptyfeeling she was on an incorrect dose?? That is worrying and no one noticed? So sorry they had to go through that, does Covid induce premature labour?

Glad to hear everyone is in the road to recovery. What an avoidable stress. Hopefully it is smooth sailing from now on.

[quote Mishmased]@ivegotanemptyfeeling she was on an incorrect dose?? That is worrying and no one noticed? So sorry they had to go through that, does Covid induce premature labour?

Glad to hear everyone is in the road to recovery. What an avoidable stress. Hopefully it is smooth sailing from now on.[/quote]
Yes - the dose was far higher than it should have been.

Yes - a doctor told her that this was her body's way of dealing with the virus. They've also told her she now 'probably' has long covid as it has left her with a chest infection. She tested positive in the last half term. Her daughter (4yrs) had three weeks off school as a result of this.

She looks terribly ill.

Sorry your daughter went through that OP, it happens a lot where women are dismissed during pregnancy/labour, and it's awful. No doubt they did advise according to the info they had re: unlikely to give birth within 2 weeks, but evidently she was ignored. I would encourage her to speak to PALS, the important thing to remember is that it isn't about getting people 'in trouble', but contributes to training, identifying areas for improvement, and if neccessary actions are taken. She should also be able to request a debrief when ready, I had one the day after I gave birth, and then a longer one 6 months after when I felt ready to discuss.

The fragment wouldn't be an issue I've taken throughout my pregnancies and for 6 week post partum. I was fine it's safe and unlikely to lead to excessive blood loss. It also wouldn't have contributed to her early labour.