HELLP and epidural.

[atvlady]

For you ladies that have had HELLP and went on to have a HELLP free pregnancy and/or for you ladies that was diagnosed with HELLP, did you have a epidural? Did your dr advise you not to have a epidural? I know when I delivered with Darren, they wouldn't let me have a epidural cause my plateletes were low and the epi would have lowered them more and I would have hemoraged into the epi space and could have had bad consequences. Anybody have any experience to share?

[jenmatt1]

I had same issue. The anestesiologist came in to talk to me. When I first went to hospital my platelet count was about 65K- which I guess is right on border. Within 2 hours it was 50K so they would not give it to me and they were going to induce me. At that point, my daughter's heart started racing in utero (probably because she sensed my panic) and they decided to do an emergency c-section. By time I was finished with delivery my platelets were about 30K and I had to have 2 platelet transfusions.

I have discussed this all with my doctor for this current pregnancy. I have decided to have c-section. For me the risks of vbac were not worth it. She said they would test my platelets and if low, they would need to put me under anestesia than the epidural. I am actually ok with that. I'd rather not take any chances with this pregnancy. I am also scheduling c-section for 37 weeks and not going beyond that point. My doc is ok with that plan for now, although she said we'll talk more as we get into the 3rd trimester. My hope is that I make it there to that point in this pregnancy, before HELLP or PE comes on.

[atvlady]

Sorry to hear of your trouble but glad you had a good pregnancy outcome! I am deciding that IF I have to have a c-section, I will have general anesthesia. If I go naturaly, which is my goal, I will do it with no pain meds. The contractions wasn't bad last time but I dilated so fast but every pregnancy is different. I was just curious as to what other women done or their current plan. Thanks for sharing!

[heather j]

They drew stat labs in L&D the night I arrived with the abruption, and my labs were good enough to have a spinal and section at that time (and I arrived just in time in all respects). Within 12 hours of delivery, they'd dropped to 50K. With my next c-section (non-emergent and somewhat scheduled), I had discontinued ALL anticoagulants 48 hours prior, they drew labs to be certain I was in the clear, and we proceeded with the section with an epi. No complications either time from the spinal/epi.

[amandaoasis]

I think it really depends on what your platelet levels are. Mine were 117,000 when they induced. I was able to have the epidural without any complications. If they catch the HELLP early enough and your platelet levels are not plummeting, I think they will let you have one.

[sezza]

i had a general anesthetic with my first child as they were not worried about my platelet levels but were worried that something might happen and they would not have time to then give me a general if i had had a spinal. in saying that my platelet levels were really low when i presented so there was no way that i was going to be induced.
for this pregnancy i am just going to see what happens. we are at 35 weeks so far. am hoping for a vbac as they are so much safer than repeat csection so hopefully health will stay good. if we did have to have a csection though i would rather have a spinal. feels like i missed such a big moment of my life by being asleep!!

[jenmatt1]

my understanding is that some will not give an epidural if under 100K, others will give it in the 65K-70K range. My anestesiologist re-ran labs because the 65K number was a few hours old and it was on the border for what he felt comfortable with. The 2nd labs were lower so he would not do it because he said you could bleed out and have further complications during the pregnancy. At that point, I thought I was still going to be induced- just no epidural- but then things changed for the worst. Kind of glad though. My hubby was in another state for work and not there yet. Not sure I could have gone through that by myself considering everyone kept on saying how sick I already was. I think this is just one of those things you have to prepare for all options for.

[milesymommy]

I was able to have an epidural with both preganacie - first w/ PE/HELLP, second only PIH.

[sathede]

I underwent an emergency C-section with general anesthesia due to HELLP. Platelet levels dropped to 54k so epidural was not an option. I had been hospitalized for 6 days on bedrest and was being closely monitored for PIH and proteinuria. My platelet levels dropped fast as my BP and liver enzymes also elevated at rapid rate. We would like to have more chidren but I was cautioned to wait for at least 2 years. How long have others waited to TTC after a HELLP pregnancy?

[atvlady]

Thanks everyone.

sathede I have had to wait til my health was optimal for another pregnancy and 15 months PP it is finally there. From what I can tell a good bit doesn't tempt fate again but the others usualy about a year after all underlying tests' are done.