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Thalassemia Patients and Friends and thalpal Ā© A. Battaglia 2018





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Author Topic: C-Section Delivery Question  (Read 627 times)
Merscan
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« on: January 29, 2018, 09:26:41 AM »

Hi, I am new to this group. My daughter has Thal Minor and is scheduled for a C-section because baby is Frank Breech. My question is about the surgery with Thal Minor. I have read that low hemoglobin can cause excessive bleeding during surgery, but I have also read that Thal Minors have clotting issues as well? Does anyone have any information on this? Trying to gather all my information before we meet with the hematologist again. 
Her hemoglobin is normally around 11. Has come down to 8.3. Last visit, it was up to 8.9. Her ferritin has come down. Was 34 then down to 17. They had her start iron once a day. It is now 14. I am not happy that her TIBC is increasing though. She is 33 weeks right now. Any advice please?

PS - I am going to make another post in some discoveries with gestational diabetes and low hematocrit.
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Andy
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« Reply #1 on: January 30, 2018, 07:25:22 PM »

As a precaution, preparations for a transfusion should be made before the C-section, mostly because her Hb is close to 8. This is often a standard practice when the Hb drops this low in thal minor pregnancies, and isn't cause for alarm. It's usually just a precaution, but once in a while, the mother will need some blood.
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Andy

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Merscan
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« Reply #2 on: January 30, 2018, 08:50:11 PM »

Thank you for the response Andy. It's so hard to get information about this. So happy to have found this site. Her hemoglobin has gone up to 8.9. I am hoping at the next hematologist visit next week, that it goes up again.  I have read that it usually goes the lowest in the second trimester so hopefully it goes up from here. I was worried about transfusion, but we will keep monitoring.
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Merscan
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« Reply #3 on: March 12, 2018, 10:48:35 PM »

Hi Andy. My daughter delivered on Saturday. Her hemoglobin came up to 10.4 on it's own. My question is do you know if thalassemia minors clot at all after delivery? She had a c-section, and in recovery, she started clotting so they had to work on her a little. All is well now, but I am wondering if additional precautions should be taken after delivery? Thank you!
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Andy
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« Reply #4 on: March 15, 2018, 07:10:44 PM »

Congratulations! I'm happy it went well.

I would think the clotting is from the same problem that causes many miscarriages in thal minors, the hypercoagulable state. This rectifies in thals after the birth, so there should be no lingering problems.
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Andy

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Merscan
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« Reply #5 on: March 17, 2018, 10:19:15 PM »

Thank you Andy. Do you think this can increase the risk of thrombosis? It has been 7 days since delivery.  I am so thankful for this forum. When the doctors hear thalassemia minor, the automatically say that it is non-systematic. I wish there was more of an understanding of it during pregnancy.
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Andy
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« Reply #6 on: March 22, 2018, 06:23:36 PM »

Thrombosis shouldn't be an issue after the pregnancy. Even though the problem exists in thal minors, it is mostly a problem only during pregnancy, when the blood flow between the uterus and placenta can become reduced.
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Andy

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Merscan
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« Reply #7 on: March 26, 2018, 09:40:29 PM »

Thank you for all your information Andy!
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