Antiphospholipid syndrome (APS) planned csection

[Soph903]

Hi everyone,

Just looking for some reassurance or advice please! We are due our first baby in August, have had multiple early miscarriages though. We've been told I will need a planned induction or csection at 38-40 weeks due to my antiphospholipid syndrome but have heard that most early inductions don't go to plan so we're thinking a csection may be the better choice?
Also heard other people with APS have had planned induction/section around 37 weeks so am slightly concerned as to why they are leaving it longer for me, been told to stop aspirin at 36 weeks and continue heparin all the way till after birth.

Any advice is appreciated, thankyou x

Hi OP, I have APS and have had multi MC either side of having my son 6 years ago. When he was born I was on aspirin and fragmin for the whole pregnancy and 6 weeks after. I had a normal vaginal delivery at 41.5 weeks with no complications. It was afterwards there was an issue because 3 days after birth, I felt really poorly and it was discovered I had retained tissue in my womb and it had got infected, most probably caused by the APS.

Sorry edited as I posted too early! I was given antibiotics and I had the tissue removed via vacuum under general anaesthetic but I recovered quickly. Just make sure you get a second opinion about stopping your blood thinners at 36 weeks because a lot of consultants believe it will lead to clots after giving birth if you stop. Get a few opinions before you decide your plan of action. X

I had a planned section booked for 39 weeks. Wasn’t told to stop taking the heparin or aspirin until the booking in session a few days before. I didn’t make to the booking session as I went into labour at 37wks. Still had the section and was the most amazing experience of my life. No complications, such a calm relaxed birth, felt so magical. I would do it again in a heartbeat!!

I think the advice is to leave it as late as possible, and with a section it’s pretty straightforward as if you go into labour early they can still accommodate and you’re already prepared for it.

sorry, as an edit, I can’t remember if I was supposed to stop taking the aspirin. I would have followed the advice, but I definitely kept taking the heparin

Hi,

Thankyou for your replies! I've been told to stop aspirin at 36 weeks as it takes a couple of weeks to 'leave your body' and could increase risk of bleeding during birth otherwise. The heparin I would just temporarily stop for 48hrs for the birth but otherwise won't come off of it properly until 6 weeks after birth. I will definitely look into trying to get a second opinion thankyou. X

I took heparin as usual the night before my section ( as I didn’t know I was having one as went into labour early), had no problems with bleeding. Just carried on with the heparin for 6m after. I was home in under 22 hrs and that includes waiting for a slot for the section!

I was diagnosed with APS when pregnant with DS, like you after a few miscarriages. I was on aspirin right up until birth and a break of 48hrs of the blood thinners just to accommodate the C-section.

I was originally due to have DS at 39w which is par for the course for most sections, but from about 28w they picked up he was measuring small, as in <5th percentile. By about 35w they were worried his growth was plateauing which can be an indication of an issue with the placenta (but also not uncommon where the mother has APS), so he was born at 37w on the dot, 5lb 8oz. Had the weight concerns not been picked up during my scans they would have let me go to 39w.

I’d had a straightforward section with DD three years previously so there was no doubt in my mind that was what I wanted with DS. It was a very overwhelming feeling sitting in the theatre as they did the epidural, I started crying and they had to faff about trying to find me something to wipe my tears with! It was just so emotional knowing I was finally at near the end of a very hard road and I was about to meet this baby I’d wished for for so long. He’s 1 in two weeks and I still get teary thinking about it!