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Clotting in pregnancy and postpartum

Birth, Podcast

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Clotting in pregnancy and during the postpartum period can be a significant concern for a new Mum. To treat clots, doctors will try to adopt a preventative approach and prescribe anticoagulants during pregnancy and the postpartum phase to reduce the risk in at risk patients.

But who is an at risk patient?

Will the baby be affected?

In this episode, we are discussing everything you need to know about clotting. Pregnancy increases your risk of clotting by 5 to 10x and the postpartum period increases your risk 15 to 35x!

We’ll talk about the different factors that increase your risk and the type of preventative measures that doctors will prescribe. We’ll go through exactly what you can expect when taking anti-coagulants during your pregnancy and after you’ve given birth. To ensure you have the full picture, we’ll discuss the signs and symptoms of a clot and explore how your hospital will diagnose it.

The potential of developing a clot can understandably cause anxiety in new Mums so we wanted to inform you all about how this is prevented, diagnosed and treated to assuage your concerns. Let us know if you have any questions or thoughts on this topic, we’d love to hear from you.

TOPICS DISCUSSED
[0:48]: Read out of a review. 

[2:36]: The topic of this episode was requested by two listeners who asked for more information on blood clots and anticoagulation. 

[3:24]: Pregnancy and the postpartum period is a risky time for blood clots. It’s one of the reasons people with very bad pregnancy outcomes would run into significant trouble. 

[4:00]: We’re talking about spontaneous abnormal clotting that happens within veins. This can happen in deep veins in the legs, pelvis, arms, and in the brain. Clots in the brain can cause a stroke. Clots in the legs can cause a DVT and spread to the lungs and be potentially life-threatening. 

[4:50]: Pregnancy powerfully increases the risk of clots. You are 5-10x more likely to get a clot when you’re pregnant. 15-35x more likely to get a clot in the postpartum phase. Modern obstetric management tries to pick who’s at high risk and treat them preventively so they never have a clot in the first place. 

[5:22]: Everyone is at some risk. Blood will pool in veins that are dilated. Dr Pat runs us through why clots happen more often in pregnancy. 

[7:24]: Postpartum is the most common time to develop clots and in pregnancy closer to term.

[7:30]: Doctors analyse risk factors to determine who should be anticoagulated. Risk factors include; you’ve had a clot before, clots in immediate family members, thrombophilias – diagnosed pro coagulation disorders, smoking, overweight, age of over 35, having a Caeseraen, and big haemorrhages. 

[10:50]: Join us for our free masterclass where we talk about the most common mistakes people make when growing their baby. 

[11:52]: If people have 2 or 3 risk factors then doctors will prescribe anticoagulants unless the one risk factor is a very strong one – such as having a clot before. 

[12:32]: Deep venous thrombosis is blood clotting in the legs. Legs will be typically painful, swollen, red, hot, and hurts to touch. It’s diagnosed on ultrasound, they will find a non-compressible vessel, or they will measure doppler flow. 

[13:54]: Pulmonary embolism presents with sudden onset shortness of breath, chest pain, cough, coughing up blood, they look sick and may collapse. It’s diagnosed with a lung scan – CTPA, VQ Scan. 

[15:12]: The risk to the baby is via the risk to the Mum. If Mum becomes very unwell with a blood clot and has falling oxygen levels then the baby doesn’t have enough oxygen. The anticoagulant Clexane doesn’t cross the placenta and it doesn’t affect the baby or breast milk. 

[15:56]: Caesarean section can be clot provoking so Clexane is prescribed for 3-5 days after birth, sometimes up to 6 weeks, and for some clotting conditions up to 3 months. 

[16:55]: If you were taking preventive Clexane, the doctor will ask you to stop this the day before the planned Caesar to allow for clotting during the procedure. 

[18:02]: Doctors may induce the baby after 38 weeks so they know precisely when to stop the Clexane, have the baby, and then get back on Clexane the next day. 

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