c/s & haemorrhaging

[busylizzy]

I'm due to have a c/s in 11 days & it's just come to my attention from reading posts in the last couple of days that alot of women seem to have experienced haemorrhaging in the process of c/s operations. Just wondering if anyone can tell me why it happens, what causes it & are some people more prone to haemorrhaging than others? I'm starting to get a little scared now. Is it really that common?

[tickle]

I haemorrhaged as I had placenta previa and the placenta was right down the bottom of the uterus and didn't contract as well as what it would further up. Does that make sense? They couldn't stop my bleeding with stitches so I had a catheter like balloon put there for 24 hours to hopefully stop it. That worked like a treat.
I knew I was at a high risk of a bleed because of the previa. If you don't have complications to begin with you are at a lower risk. I'm sure it will go perfectly.:hugs:

[PhAnToM]

Well, ignorance is bliss isn't it? :D

I have had 2 c/s, went in blissfully ignorant.. so I wasn't really concerned or aware of what could go wrong. I left myself in my obst's capable hands and came out a winner.:thumbsup:

I never had hemorraging in either c/s. In fact my records clearly state that I had surprisingly little bleeding during the cesarean. In the first one, my obst even said it to me just before i went off to recovery.

Please don't worry about it.
I know it's hard not to when you read about not so straight forward experiences. But I think it's because you tend to hear from people who have had negative experiences more than those who have had good experiences, like with most things in life.

I'm sure you'll be fine.
:fingerscrossed: for you.

[Buddha Bubbas]

i had a c/s and lost nearly 2 litres of blood and had a transfusion. dont know why. i never even thought about what could happen with a c/s. i guess i kept thinking nothing will go wrong and i will be fine after it. had a traumatic time as i was so sick couldnt hold bubba for the first couple of days for more than 5 minutes. i think this is why the thoughf of a c/s puts me off so badly now. ive had other people say they were up within a couple of hours and fine and went home in 2-3 days. everyone is different and i wish you all the best for a safe delivery and speedy recovery :fingerscrossed: :)

[Briannabear]

The doctors sort of explained the reason why I heamorraged badly and needed a transfusion like this - Id had a very long labour leading up to the operation and my body was very worn out before they even started. Not sure if there was another reason or not, but thats all they said.

Like someone else said, try to keep focussing on positives rather than all the negative things that can happen.

All the best for a fantastic experience! :fingerscrossed:

[tickle]

I think the best thing you can do is to research the risks, then you know what the chances are of something happening and know what is going on around you if it does. It is true that you do hear about the negatives and there are a lot of positives from caesareans, even though we had problems, if I hadn't had one both my dd and I would have died. A caesarean is life saving and if there are complications that make a v/birth impossible then it is the safest option for you and your baby. Don't stress over to other things, just inform yourself and it will be fine I'm sure.:hugs:

Here's some info for you:


When a cesarean is done, the risks and benefits of the procedure need to be weighed. This includes looking at the added benefits and risks of doing a cesarean or of birthing the child vaginally. Sometimes the benefits of the cesarean will outweigh the risks, and sometime the vaginal birth benefits will outweigh the risks of the cesarean.


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Cesarean birth is major surgery, and, as with other surgical procedures, risks are involved. The estimated risk of a woman dying after a cesarean birth is less than one in 2,500 (the risk of death after a vaginal birth is less than one in 10,000). These are estimated risks for a large population of women. Individual medical conditions such as some heart problems may make the risk of vaginal birth higher than cesarean birth.

Other risks for the mother include the following:



Infection. The uterus or nearby pelvic organs such as the bladder or kidneys can become infected.
Increased blood loss. Blood loss on the average is about twice as much with cesarean birth as with vaginal birth. However, blood transfusions are rarely needed during a cesarean.
Decreased bowel function. The bowel sometimes slows down for several days after surgery, resulting in distention, bloating and discomfort.
Respiratory complications. General anesthesia can sometimes lead to pneumonia.
Longer hospital stay and recovery time. Three to five days in the hospital is the common length of stay, whereas it is less than one to three days for a vaginal birth.
Reactions to anesthesia. The mother's health could be endangered by unexpected responses (such as blood pressure that drops quickly) to anesthesia or other medications during the surgery.
Risk of additional surgeries. For example, hysterectomy, bladder repair, etc.

In cesarean birth, the possible risks to the baby include the following:


Premature birth. If the due date was not accurately calculated, the baby could be delivered too early.
Breathing problems. Babies born by cesarean are more likely to develop breathing problems such as transient tachypnea (abnormally fast breathing during the first few days after birth).
Low Apgar scores. Babies born by cesarean sometimes have low Apgar scores. The low score can be an effect of the anesthesia and cesarean birth, or the baby may have been in distress to begin with. Or perhaps the baby was not stimulated as he or she would have been by vaginal birth.
Fetal injury. Although rare, the surgeon can accidentally nick the baby while making the uterine incision.



From: http://www.childbirth.org/section/risks.html

[Pixie]

I heamorraged as I had laboured so long my uterus became like butter, I tored down both sides of my uterus I lost 2.5 litres of blood and had a transfusion while stitching me they said it was like a Knife in hot butter so it took a while.

I asked at my de-briefing why I tore and how common it was this may not be something you want to hear! He told me that more than 1/2 the women who have a ceasar hemorrage in some degree or another, mine he said was rare it's very unusual to lose that amount.

So based on what I know now, for my 2nd child I will be monitored closely my first c/section was an emergency, so at around 34 weeks they will tell me what my options are to avoid bleeding they recommend you don't labour, have your caesar planned, you have your c/s planned so the likelihood of you labouring is probably slim. With any major surgery there are risks, a c/section is a huge operation they cut through skin, layers of fat and muscle and your uterus.

Hopefully it all goes well I hope I didn't scare the ba-jeepers out of you!

[Kaileysmum]

I had a emergency c/s after a long labour. Once they cut me open my uterus went into shock from the long labour. I started to bleed and they tryed to give me the contracting drug (cant remember what its called) and it didn't work for me at all. So thats why I hemorrhaged and needed a transfusion. They actually had to take the placenta of my uterus wall and burn all my blood vessels closed to stop the bleeding.

I think you are more likely to hemorrhage if you have a emergency c/s.

[~beckkles~]

I had an elect ceaser and ended up requiring 2 litres of blood. I think my problem was that they didnt realise that the placenta was as low as it was and cut through it. It is amazing how cool all the staff are as you hear there is a loss of 1 litre 2 litre. I had ultrasounds every week from 16 weeks too it is amazing how they missed it
Bec

[~Chick79~]

I have had 2 c sections and both times they were smooth operations! My recovery second time round was even better then the first!

Like with any op though there are risks and every operation performed on a patient is different - your experience will be your own!

And just for another angle... there is also risk of haemorrhaging with a natural V birth....

Best bet is to discuss all this with your OB or midwife (you should have also been given a hand out when booking a planned c section...)

[~beckkles~]

Yep I haemorraged when the obst snapped my ambilical cord trying to pull the placenta out
Bec

[busylizzy]

Thanks guys for all your replies, especially Tickle for the great info:thumbsup:. I feel alot more prepared as well as confident knowing that it is an elective c/s with a very well respected ob. So hopefully things will go well (I'm going to stay positve), it can't possibly be worse than my vb last time. I'll let you all know how it goes. Thanks again. Liz:).

[tickle]

No worries Liz, anytime.:D
Can't wait to read your birth story, I'm sure you will have a great experience. It is the weirdest feeling the morning you go in, just knowing that your baby is about to be born. So exciting.......almost (and I mean almost;) ) makes me want more.:p
:hugs:

[TigerBlueBear]

A caesarean is major abdominal surgery and like all surgery their is a risk of haemorhaging because blood vessels may be cut.

When the surgery is done they cut through a layer of skin and fat and several layers of muscle tissue (although where possible they separate it rather than cut it) in order to get to the uterus. The lower segment of the uterus is relatively avascular (smaller blood supply) so does not tend to bleed an awful lot but if the upper segment is cut then there is significant bleeding because this region is extremely vascular. On rare occasions another blood vessel in the abdominal cavity (eg on the bowel, peritonium or bladder etc) may be cut and cause bleeding. There are some very large vessels in this region and also some that are enlarged because of pregnancy. If any of these are nicked you will get a large blood loss.

The other factor with surgery on the uterus in pregnancy is that the interior wall of the uterus and the placenta are also very vascular. The interior wall of the uterus where the placenta attaches is like a large open wound once the placenta removes. The natural contraction of the womb after birth serves to reduce blood flow to this area in the same way putting pressure on a cut does. OBs will ususally give you an injection of oxytocin to get this process to happen during a csec (it also aids in getting the placenta to come away) but sometimes this is not effective enough. If the placenta comes away too soon or the OB is a bit vigorous in his removal of it then this can also cause haemorrhage in a similar way to how a natural placental abruption occurs.

It should be noted that the comments made by some of the other girls that imply a long labour may contribute to the haemorrhage are not correct unless the long labour has resulted in a secondary event associated with haemorrhage such as placental abruption or uterine rupture - long labour in itself is not a significant predictor of bleeding.

If you need to have a caesarean the best thing you can do is to place your trust in your OB. As a rountine they will do blood type cross matching on you just incase, as although the risk of this occurring is relatively small it is still much greater than for a vaginal birth.