Hi.
Case History
2 confirmed pulminory embolisms (PEs) over 12 year period and 2 other possibles.
No identifiable medical reason - all tests done and redone.
Possible environmental cause (Dianne35 for first one, long cramped bus ride for second) but nothing clear.
Delivered a previous healthy baby vaginally by induction (took 5 attempts 3 at 37 weeks, 2 at 39 weeks). Waters had to be broken on fifth attempt to get it going. Was on clexane (and then tinziparin) throughout pregnancy but stopped for birth. Had epidural on tap (drip feed type one). Was managed by a 'high risk' team at an excellent hospital with a wonderful Obstetrician. My labour was 3mins 36 and took 4 contractions (with pushes) to get baby out once I was allowed to start pushing as was crowing even before any pushing. Told to warn doctors in any future pregnancy that I had a fast labour - as it may affect time needed for anticoagulation to get out of my system.
Am now 8 weeks pregnant in a different area. There is talk of not inducing and allowing me to go into labour myself presuming I get that far and don't miscarry. They say they are not 'so conservative'. The reason the previous hospital hadn't wanted a natural labour was because of managing my coagulation level and the risks in 'operating' if an emergency occured, such as c-section needed, along with the increased post-operative c-section risks (throwing a clot).
Questions - Looking for an idependent view from a medical expert...
What are the medical guidelines for a woman with a multiple PE history on anticoagulants (herparin) for delivery? Is early induction usual? Is going into labour naturally usual for such a history? Do you know of such cases or appropriate readings I could access on the web?
Why
I was very involved in discussions at the last hospital and understood their thinking. We worked together to get a good plan. The attitude looks to be quite different so far in my new area so I want to go in as informed as possible so that I know what questions to ask. I don't know whether it is usual practice to allow labour to develop naturally with a PE history and on anticoagulants.
