Wednesday, December 29, 2010

Inherited Danger? Fluke? My Experience with Blood Clots

Pregnancy and childbirth are two of the most exciting times in life. For some of us without access to our medical histories, however, there may be unexpected, and in some cases preventable, complications that potentially threaten the life of the mother and/or child.

During your first prenatal visit, doctors will typically ask you about your family history to check for a variety of conditions that would require more careful monitoring. Since I do not know half of my medical history, a large portion of my answers were blank. As far as I knew, my diabetes and maternal family history of Down syndrome were my only concerns. I anticipated a "normal" pregnancy and delivery.

Three days after I delivered my son, Trevor, earlier this year, I developed a blood clot that hemmoraged and required a surgical procedure to fix. Assuming the clot was just a fluke, I never researched it or suspected that perhaps there could be a genetic component. In my current pregnancy with my daughter, I again developed a blood clot right by the baby along with a condition called placenta previa. Curious as to whether this, too, was a fluke or perhaps something else had contributed to these clots, I googled blood clots and previa. Only a few risk factors were identified, of which genetics was the only possible listed predisposition that might explain my complications. (Other risk factors included history of cocaine use or cigarette smoking. I have never smoked a cigarette in my life, much less used cocaine. I did not have any of the other risk factors, either.)

If, by chance, there is a known history of blood clots in my paternal family, I could have warned the doctors and they could have taken extra precautions to prevent the first one from ever occurring much less hemmoraging. Once you develop one clot, I have been told that you remain more prone to developing additional clots - even those unrelated to pregnancy - in the future. Once you develop a blood clot that requires uterine surgery to correct, as mine did, you are also more prone to blood clots and previa in subsequent pregnancies. In worst case scenarios, both the mother's and baby's life is in jeopardy due to the risk of loosing a lot of blood quickly.

So far, I have had one healthy, happy baby. Until my daughter is viable, though, I may have to worry about how my little girl is doing and hope that she gets the necessary time to develop. If I hemmorage and it stops, my baby has a chance. If I hemmorage and it does not stop, my baby must be delivered, even if she is too immature to survive. Perhaps with access to my medical history, assuming that mine has a genetic component, this would never have happened in the first place and I would have more confidence that my children in the womb would be okay. Either way, this is just another example of why knowing our entire histories may help us and our kids stay healthy.

Update 1 - The previa is showing significant signs of improvement, and this blood clot has now completely resolved itself! Although I have been instructed to take it easy for my entire pregnancy to hopefully prevent another clot, the baby girl is in a much safer environment now and should be ok. (Thanks, Stephanie, for your thoughts.)

Update 2 - The previa eventually resolved completely. However, Lexi's growth percentiles dropped significantly and steadily. Another blood clot had gone undetected and hemmoraged during my induced labor. Due to her lack of proper growth in utero from these complications and the high risk of being stillborn, she was induced early and is now doing much better outside the womb.


Stephanie said...

How terrible, Kathleen! Congratulations on the newest little one, though. I'll be praying for you.

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