WOMENS-HEALTH Messages for October, 1998: Re: Hemabate postpartum?

Re: Hemabate postpartum?

From: William D. McIntosh, MD (anonymous@obgyn.net)
Thu, 29 Oct 1998 14:08:55 -0600 (CST)

Messages sorted by: [ date ][ thread ][ subject ][ author ]
Next message: Christy: "Would cysts cause me to bleed so often?"
Previous message: rhonda: "do some birth control pills cause anxiety?"
In reply to: Leigh: "Hemabate postpartum?"

At Thu, 29 Oct 1998, Leigh wrote: >
>Might I pick you good doctors' brains? I gave birth 2 weeks ago and was
>given a medication called Hemabate (I'm sure I've spelled it wrong)
>twice following the birth. I know nothing about this medication. My OB
>said it would make me sick for about 20 minutes (more like 4 hours) and
>I ended up needing Nubain and Phenergan to alleve my distress (this
>after a completely natural birth...I was crestfallen!)
>
>If it helps to know, I had a marginal placenta previa which caused a
>great deal of blood loss (hemaglobin dropped from 11.6 to 8.3) as well
>as a placental separation and a velamentous cord insertion. My labor
>started at midnight and I gave birth at 1:41 am to a perfect, healthy 8
>pound, 13 ounce daughter. I also have a mild blood clotting disorder.
>
>What is this stuff and is it safe? I still don't understand why I needed
>this instead of pitocin or something.
>
>Thanks so much,
>
>--
>Leigh
>

Hemabate is a medication that makes smooth muscle contract very powerfully. It is targeted at the uterus (which is the largest concentration of smooth muscle in the human body) in women that are having a post-partum hemorrhage. It is a safe and effective drug, but it does have the potential for very uncomfortable side effects, including severe diarrhea and nausea with vomiting. The most irksome side effect is the powerful uterine cramping that is also the whole reason for giving it in the first place, sort of a benefit and side effect rolled into one.

After separation of the placenta, the potential for blood loss from the uterus is enormous. The blood flow to a term uterus can be >500cc/min, enough to permit a woman to bleed to death in just a few minutes if not controlled. The blood flow is too fast for clotting to halt the blood loss, but your body has a wonderful mechanism for dealing with this problem. The uterus contracts, cutting off this potentially torrential blood flow. This process is frequently assisted by some combination of IV pitocin and uterine massage. I am not going to get into whether pitocin is "of the Devil" or not, but that is a very common use for it. I would bet a lot that your doctor uses pitocin post-partum as a routine.

There are a number of conditions that can interfere in this process, such as infection, incomplete placenta removal, uterine rupture, and so on. You had one of these conditions, namely a low-lying placenta. The lower uterine segment has very few muscle fibers compared with the fundus, or body, of the uterus, and therefor cannot contract as well. Since your placenta was attached in this area, the uterine contraction that you could muster yourself, or with just pitocin, was inadequate to stop your bleeding. Hemabate is designed for this specific problem. Without it, you may well have lost a lot more blood, even have had surgery to stop the bleeding. Such surgeries can result in sterility, or even a hysterectomy. As it was, you are on the borderline for needing a blood transfusion.

-- William D. McIntosh, MD Clarksville, TN

This is for educational purposes only. It is not intended to replace consultation and examination by your physician or other health care provider.

Next message: Christy: "Would cysts cause me to bleed so often?"
Previous message: rhonda: "do some birth control pills cause anxiety?"
In reply to: Leigh: "Hemabate postpartum?"

Women's Insurance Checklist from Auto Insurance Quote

use when must restrict search to only the women's health forum...
Enter search keywords:
	Returns per screen: Require all keywords: