WOMENS-HEALTH Messages for February, 1998: Re: Postpartum Hemorrhage

Re: Postpartum Hemorrhage

From: andrea (anonymous@obgyn.net)
Tue, 17 Feb 1998 16:45:10 -0600 (CST)

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At Thu, 6 Nov 1997, Garry E. Siegel, M.D. wrote: >I read this exchange with great interest. My situation is similiar and I have many of the same concerns, but my story is different. I am 28 and in otherwise good health. My (my first) baby was 7lbs. 13 ozs. I was induced on my due date which was set by ultrasound. My placenta was intact at delivery. I went into "DIC", medication did not stop the hemmorhage. Finally, a d&C did. I received 6 transfusions of various blood parts. I stabilized and went home days later. I could not walk without assistance when I went home. This quickly degenerated and I was wheelchair bound for 1 month. MRIs showed edema in my left pelvis and hip areas. I have been told that i am a medical mystery. My bloodwork before and 3 weeks after delivery were completely normal. No one can explain why or how i hemorrhaged,why my platelets failed, or why I couldn't walk. I have been told that "lightening doesn't strike twice", so it will be fine for me to have another child. What can I do to ensure that I don't go through this again? Your suggestions for Terri don't seem to really apply to me.
>At Thu, 6 Nov 1997, Terri wrote:
>>
>>What a great source of information! My question has to do with the
>>likelihood of experiencing a second pospartum hemorrhaging experience
>>with a second child. I had an awful post delivery experience with my
>>first son, two weeks late, 9.4 lb baby, placenta came out in pieces...
>>After going into shock, getting three D&C's, and three blood
>>transfusions, the bleeding subsided seconds away from a hysterectomy.
>>The recovery was awful but I feel lucky to be here enjoying my beautiful
>>son. The attending Dr.'s said that I would have died years ago and the
>>medicine that stopped my bleeding was only avialable 7 years ago. I
>>have discussed this with several local Dr's from different firms to get
>>an opinion of what happened, to ask if I should consider another child,
>>and what can be done the next time to prevent this from happening again.
>>
>>One Dr. with another firm was familiar with my case as I began to
>>explain it! They say they wouldn't have done anything different, and
>>would encourage another pregnancy. If I become pregnant, they all said
>>I would not be considered high risk for complications. Is this an
>>acceptable response? Is there anything a Dr. *can* do to tell if my
>>uterus just doesn't contract so we can anticipate and plan for problems
>>instead of waiting for shock to happen? Would a cesearean for the next
>>child eliminate the problem? We are trying for another child, but I am
>>terrified of hemorrhaging again. I am 33, son is 2 yrs old. I am
>>grateful that my Dr. saved my life and my uterus, I would just like to
>>know how/if we can prepare for next time. Even have my own blood on
>>hand would ease my mind.
>>Thank you! Terri
>
>Terri:
>
>Sorry you had such a tough time, and I tend to agree with most of what
>you've heard.
>
>I would not recommend a C Section, and there may not be anything that
>you can do to prevent problems. I would not call your pregnancy high
>risk, but I would have to think that you remain at a higher (and I
>really don't have a percentage number for you) risk for another
>hemorrhage. I would not let that stop you from having another baby.
>
>Suggestions:
>
>1. Why don't we have a smaller baby!!! While I don't advocate smoking
>or drinking (just kidding), try to limit weight gain to 25 pounds, and
>delivery earlier than 2 weeks past your due date might not be a bad
>idea. It would be a good idea to have an early ultrasound to make sure
>your due date is well confirmed.
>
>2. Get your iron count (hematocrit, hemoglobin) up to snuff before you
>are pregnant, by taking an iron supplement. If needed, stay on iron
>during pregnancy.
>
>3. Self directed blood donation while pregnant probably isn't a great
>idea, as you must lose blood that is hard to replentish fully once
>pregnant.
>
>Good luck.
>
>Garry
>
>*Note: Opinions expressed here are for educational purpose only.
>This information is not intended to supplant the need for you to
>consult with your physician prior to choosing therapeutic options.
>
>**Private emails cannot be entertained due to time constraints,
>consequently no private emails will receive a response.
>**Thank you for your understanding ;-)
>
>thanks, Harv--GES
>
>--
>Garry E. Siegel, M.D., FACOG
>Private Practice
>Roswell, Ga.
>

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