Previous postpartum DVT - what happened in your next pregnancy?

[PerspicaciousGreen]

I had a postpartum DVT develop two weeks after birth last time. It got quite bad before it was diagnosed as it was in an unusual place in my thigh and presented in an unusual way. I took oral blood thinners and it got better, although I still get the odd twinge in that leg (and weirdly it's one of my PMS "tells" for my period!)

I didn't have any risk factors and I am of the opinion that I basically just got unlucky. I'm not madly keen on the idea of prophylactic blood thinners as I understand it can increase risk of haemorrhage in labour (which I borderline had in my first pregnancy).

I'm only nine weeks but am seeing the consultant on Wednesday and I'd like to know what the usual pathway is and therefore what she might suggest.

My trust follows the RCOG guidelines, which state that you should have blood thinners (prophylactic dose of Dalteparin or similar) from the start if you have a risk score of 4 or more. A previous VTE gives you a score of 4 on its own. So I think it's highly likely they'll suggest blood thinners from the start.

I should add, I had a score of 3 so I had to start dalteparin at 28 weeks. They give you guidance about when to stop taking it so you don't have problems in labour.

Thanks for the RCOG guidelines. I was having real problems finding info about prophylaxis rather than treatment online. Is dalteparin injections? I was able to have oral meds postpartum because I cried when the A&E nurse injected me and begged the doctor not to make me do it every day!

@PerspicaciousGreen I developed a clot after the birth of my daughter, this time I've been put on tinzaparin injections and have had to inject everyday from 20 weeks xx

I guess it probably depends on which area of the country you're in. Here, it's dalteparin. The dose is quite a lot lower than the one they give you if you actually get a blood clot. But yeah, it's a lot of injections

www.rcog.org.uk/globalassets/documents/guidelines/gtg-37a.pdf

Urrrrggghhh... Injections... Trying to view it as a chance to build character! But it really effing hurt!

@PerspicaciousGreen they are really honestly not that bad at all! I just get my husband to do them for me, xxx

I'm only 9+4 but had my "how to" session today and have come home with a goody bag of needles. It was not loads of fun, but the midwife was extremely patient and it was not as bad as I expected. I just wish I could do it without having to look! I didn't get it in deep enough first and had to look while pushing it fully in. Mind over matter... I'm sure in a few weeks it'll be nothing at all to me!

@PerspicaciousGreen can you get your partner to do it? X

I'd rather do the stabbing myself. I did entertain the idea of having him watch so he could tell me when it was in so I could just look out of the corner of my eye, but he begged me not to ask him to help but if I couldn't do it any other way he would, and I thought that was fair enough!

I've just done my first at-home one all by myself. I'm well proud! I put a song playing on my phone and said that it'd all be over by the time the song finished. And I imagined how good it would feel to bump into the midwife who taught me and knew how nervous I was and to tell her I'd been doing it all by myself every day and how pleased she'd be.

It's easier for me having such a slam dunk risk factor. There's no way I can weasel out of the fact that I've just got to do it. If it was just "oh, your BMI's a bit high so to be on the safe side..." I'd be finding a million reasons why I was very low risk. But I like walking and not being dead, so I shall woman up!

Thanks for the info and tea and sympathy. I'm due in November and have to do them six weeks postpartum as well so I can't believe how many injections I'm going to have to do, but I'm trying to take them one at a time.

I hope you find them ok! I've been doing them for a few weeks and I feel quite used to them now. I have given myself one massive bruise (I guess I hit a little blood vessel that day?) but otherwise it's been ok.