Post partum hemmoraging??

[MrsBump]

Hi all,
I am asking for a friend, she has had 3 children already and is 29 weeks pg with her 4th, she has VB's and always has postpartum hemmoraging. That bad that she needs the syncocin(sp?) 4x stronger than what they use for induction to clamp her uterus shut.
So my question is, Would it be better for HER to have a c-sec rather than VB? Oh and after each baby its worse. This is definately her last one as she is suffering high blood pressure and GD and starting to get bells palsy.

Thanks in advance. And Mods sorry if this is in the wrong section...

[Nuddle]

has she ever tried to have a natural third stage? I have done some reading recently that found it actually leads to less bleeding if you let your body get rid of the placenta naturally, rather then be injected with the drug, and have the midwifes pull on it, making it come away before its ready.

[MrsBump]

I am not sure, i have had my placenta naturally and i actually hemmoraged, With the others i had the needle and had alot less bleeding... maybe i am weird, i will definately tell her so she might say something to her midwife??

[Alan]

Hi Scorpiomum
I don’t think a CS will lessen her chance of a post partum haemorrhage but it would tempt them to remove the uterus to stop the bleeding. I also think that considering not using the syntocinon Synto) as the baby is born could be a good idea. Synto works quickly once injected into the muscle and even quicker if injected into a vein. If your friend was willing she could have a cannula (needle) inserted into her arm or hand early in labour. The hospital probably does this anyway considering her past history of PPH. Then if she does bleed after the birth the synto could be injected directly into the vein.

[MrsBump]

Hi Alan, she has the syncto injected directly into the vein already. I just thought there may be a better way to stop the loss, Oh well it was worth the ask. Thanks

[Mildez]

A C/S will not stop her haemorraging. It would actually most likely make the situation worse as you loose so much more blood from the surgery then a vaginal birth and then add a haemorrage on top of that. Some women that haemorrage every time after birth can be hard to stop this happening but you can lessen the degree if you act immediately after the birth. Like administering certain drugs to help like syntocinon or syntemetrin.

We also use different drugs like misoprostil which is very effective (its a tablet thats put inside the uterus) or a balloon cathetar which is also put inside the uterus and filled with approx 500mls of warm water. It puts a volume inside the uterus so it doesn't need to contract as strongly to stop the bleeding. Its is then removed the next day after the uterus has had a chance to contract well so once its removed the uterus will generally contract back down to the size it should be with minimal bleeding. If its has happened to your friend every birth its most likely caused by poor uterus tone due to poor contractions post birth ( from a tired uterus) not retained products or blood disorder (if it was this she probably would already known she had a clotting problem) so the balloon would be very effective in controlling the bleeding. Most birthing hospitals have them. But they do tend to use the Synto infusion before using a balloon cathetar or misoprostil.

Where she plans on birthing the staff should have everything prepared for a PPH going from her history. Hopefully she wont haemorrage at all but if she does they should have everything in place to keep it under control.