C section haemorrhage

[redxlondon]

I have a planned C section next week and guess one of the big worries in my mind is uncontrolled haemorrhaging. Partly because I have some unusual anatomy so worried doctors will encounter something they don’t expect as it’s quite rare and I’m at a higher risk of haemorrhage.

Just looking for some stories of anyone who had this, and how it was handled / how you felt?

Major haemorrhage is relatively common (over 1.5l) I manage at least 1 a week as an obs anaesthetist, don't worry it's our bread and butter. We give drugs to reduce the risk if expected, use a cell salvage machine to suck up blood loss and clean and return it to you and have many drugs available to help. There's a slightly higher rare of conversion to general anaesthetic in ongoing bleeding but this will all be explained to you on the day but in short don't worry we are more than used to it

Hi op, I had a large haemorrhage with my second emergency section. It happened whilst I was in a recovery room. I was taken back to theatre, and they inserted some packing with some sort of device attached (like a balloon I think!) that applied pressure and stopped the bleeding. This was removed the next day. I also had 3 units of blood transfused, and was fine within a few days. Hope all goes well for you op.

Thank you. I’ve also been reading about how when the spinal goes in it can sometimes feel tingly or like a small shock down your leg so you have to keep still. I’m realty worried about involuntary jumping if it takes me by surprise. I assume this is also common though and the anaesthetist used to managing this?
I’m usually pretty relaxed about anything medical but for some reason I am now getting so many worries about next week.

I’m also a redhead - and read some studies that show we require more anaesthetic? Has that been part of your training or experience?

don’t understand what this means: ‘major haemorrhage is relatively common (over 1.5l), do you mean that it happens in 1.5% of C sections, or that ‘major’ means 1.5 litres of blood loss?

Presumably you’re having a C section for certain reasons, so that having been decided things are now out of your control. Appreciate its scary and have been in similar situation and worried.

Hope you receive good medical care and that it goes smoothly!

pub med article online:Excessive haemorrhage associated with caesarean section, commonly defined as blood loss in excess of 1000 ml, is frequently underestimated, but is documented as occurring in more than 5-10% of caesarean sections.

The latter - 2.6 pints

Thank you! Just need to go in with positive thoughts and try to stay calm

I though 1.5l/2.6pints seemed a crazy amount! So there’s a lower threshold for “excessive” - fingers crossed I don’t reach this, thanks for the statistics

I’m a labour ward midwife and see huge amounts of PPH. It’s our bread and butter, we have many many ways of controlling it.
I had three babies, first emergency CS and lost 1000ml, normal birth with 3rd degree tear which bled like a bugger and lost 2100ml (had a pack put in) and another 4weeks ago and lost 1000ml again which I was chuffed with 😬

Just thought I’d say I’ve had two c sections, and the anaesthetists are brilliant. They’re the person by your head, talking to you the whole way through, checking how you’re doing. The lack of control is scary, but you’re in good hands. I was having contractions for my second, didn’t pose any issue for the anaesthetist.

I vaguely remember in the haze after my first C Section (I've had two) being told casually by the surgeon that I'd lost over a litre of blood. There didn't seem to be any particular alarm or concern in the OT, I didn't notice anything at the time (probably too distracted by my new baby). It was never mentioned again!

As others have said, we who work in obstetrics regularly see haemorrhages, and are well practised in their management.

Prior to your C-section, the entire team who will be involved will get together to talk about your particular case, and any problems that may arise from it, and discuss how we'll manage it. During in the C-section, we monitor blood loss, and communicate with each other if it's ongoing and if drugs should be given to mitigate it. And finally, any management that needs to happen post surgery should a haemorrhage have occurred. A well oiled machine.

Completely understandable to be worried, but please try to relax. We'll look after you.

Can I reassure you that you're just worrying because you have no frame of reference. It sounds silly, but on the day only one thing happens at a time and you manage each thing as it happens. You're surrounded by people, support and professionals and they guide you through it. And v quickly after it starts, your baby will be out and the joy of that eclipses everything happening around you. It's normal to focus on specific worries as somewhere to hang the generalised anxiety but you might not jump (probably won't), might not haemorrhage (probably won't). You will have a baby though and that's the best bit.

I haemorrhaged with my first. Around 1.7l. it was fine tbh. They dealt with that. I sort of handed it over to them in my mind. I concentrated on my role in the proceedings ie meeting my baby.

I had haemorrhage with both my csections, on after theatre one during, both requiring transfusions but not once did I feel frightened they are very well equipped to deal with it

I have had this happen on several occasions during my c-sections (I was under generals for them) and they dealt with them at the time and it didn't require any blood transfusions. I'm assuming that is down to them being on the ball as they are focusing on that area to begin with.

No lasting effects as it was controlled in plenty time. I did have a hemorrhage after a loss of a pregnancy which required a transfusion as it wasn't dealt with in time but absolutely no issues with it happening while undergoing a c-section.

I had 2000ml blood loss at each birth.

First one was an incredibly traumatic assisted natural birth although the haemorrhage came after as a result of a retained placenta and the surgery (that I had there and then) to remove it. Was a very 'lots of people running around the room' situation and senior Obs doctors bursting in and taking over. Although the medics were wonderful it wasn't a calm or pleasant situation at all. It was scary.

Second one was during my planned c-section (which I had as a result of the first birth being so tricky). They obviously knew I'd had issues with bleeding so we're likely expecting it and again it happened as soon as baby was born and my placenta didn't want to come out with her. I lost the same amount of blood, actually marginally more . Only this time I didn't even notice, I was cuddling baby and just thought they were rummaging around a bit during the stitch up (they weren't!!).

It was the nicest, most chilled environment, and the team working on me must've just sorted it with such quiet, calm expertise that I only knew about it afterwards when I was back on the ward and needed extra monitoring. I had to go down to the high dependency ward for 48 hrs rather than straight to the normal maternity ward.

I wouldn't worry OP. These medics know their stuff. You'll be fine!

I'm having no more babies This body has done it's work.

Thank you so much everyone, just got a bit teary (in a happy way) reading these x

It's not that common, we are used to people jumping a little (happens far more with epidurals than spinals as the plastic tube goes in). Don't worry

These are some videos I've made if they help

Marginally. Anaesthetics is an art as well as a science, we titrate pain killers as needed under GA according to physiological response. It doesn't affect the anaesthetic in the spinal

The definition (on of a few) of major obstetric haemorrhage is 1.5L blood loss

It occurs in around 1 in 270 deliveries

The body adapts in later pregnancy. Your blood volume by term is about 45% higher than when you're not pregnant. It is a lot but it's not something we are very used to

Watch the epidural one too as although you won't have one the explanation is the same and the way the university cropped the videos it doesn't show up the explanation with the theatre one

I had an emergency CS and lost two litres of blood. I didn't need a transfusion only some
Iron pills. I would do it all over again for my baby!