Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

178 Doctors Online
Doctor Image
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

C-section, subdural haematoma, spinal epidural. Risk in future pregnancies ?

Answered by
Dr.
Dr. Rhea Chanda

OBGYN

Practicing since :2005

Answered : 3163 Questions

default
Posted on Tue, 22 May 2012 in Child Birth
Question: My wife had a subdural haematoma following a planned c section in Dec of last year. Drs were unable to pin down the exact cause, but as she is in her 20s (i.e. not elderly with thin blood), has no pre-existing medical conditions, her blood tests show that her blood's clotting properties are normal and suffered no damage to any blood vessels after CT and MRI examinations. The cause was put down to a spinal epidural and exhaserbated by the administration of Clexane to reduce the incidence of clots in her legs and lungs.

This has naturally made her very nervous about future pregnancies and wants to find out if it is possible this could happen again in a normal vaginal birth without the administration of clexane or a spinal epidural. Secondly what would be the protocol for starting a normal vaginal birth and then developing complications that would require an emergency c section - i.e. is it likely a spinal epidural would be administered along with blood thinning drugs similar to Clexane
doctor
Answered by Dr. Rhea Chanda 25 minutes later
Hello,

Thanks for the query.

Let me address your concerns one at a time.

Subdural hematoma rarely occurs without head trauma or in young individuals.
If this complication occurred due to the spinal anesthesia during the c section,then its not directly related with the pregnancy.So any future pregnancies that might happen will be independent of this complication.

What I meant is it may or may not happen regardless of the pregnancy.For instance,it could occur due to any other surgery or trauma and very rarely,spontaneously.
Whether she will have vaginal births or c sections is another matter altogether.
That will depend on various factors including the maternal and fetal risk factors.Any pregnant woman will go into labor at full term,but whether that can done or not depends on factors like the maternal health,liquor status,position of the fetus.

It will be your OB's call to make at the last minute.If all is well,and there are no contraindications there vaginal birth is possible.On the other hand,any development of complications could demand surgery.Then,again risk of anesthesia complications arise.

I would also like to stress that this particular complication is very uncommon.Normally in a healthy young woman,this should not happen.If no underlying causes have been identified then,it can be brought down to anesthesia complications or spontaneous.
It is only at the OR that it can be determined what drugs will be needed depending on the patients condition.

It is not normal protocol to administer blood thinners during any surgery.
Vaginal births are also not known to cause spontaneous hematomas.You have mentioned that all her labs are normal.



To summarize,if you and your wife would like more children,then it will have to be a informed decision on your part,after considering the possibility of complications during surgery or anesthesia.Its not necessary that these complications will occur again,but however minimal,the chances are there.Especially since we couldn't identify any underlying cause.

Hope that answers your query.

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
premium_optimized

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,  
Medical Procedures ,   ,   ,  
Lab Tests ,  
Medical Topics

Recent questions on  Regional anesthesia

doctor1 MD

If an anesthesiologist proceeds with an epidural incorrectly during labor, can it cause nerve damage that would make it hard, if not impossible, to reach orgasm? I m 25 years old and since I had my son 6 months ago, I haven t been able to have an orgasm and I m wondering if the epidural had anything to do with it. Sex isn t painful it feels normal but nothing feels as good. I also tore in two spots and two layers because they didn t do an episiotomy and i had no stitches afterwards but everything healed correctly with no infections.

doctor1 MD

Hello, Last April I started getting occipital injections and then went on to lumbar epidurals,mid thoracic blocks,cervicals and rhizotomys and 2 medro dose packs after the rhizotomy's I have had some of these treatments at other times over 15 years. I am losing my hair at an excelerated rate, last may I had a hair cut and the next cut was two days ago and the hairdresser wouldn't let me see the hair loss we both thought it could be Lisinopril but is from all this concentrated steroid injections and if so if I stop the injections for 3 months if I can will my hair start to regrow and when do you think the falling out my stop. My last procedure of cervical blocks was last month November. Please help me, Angela

doctor1 MD

I had an epidural injection in my cervical spine five days ago due to herniated disks and stenosis, pain and numbness in arms/hands. Immediately following the injections, my blood pressure went way up to 160/120., where I normally have perfect BP. Since the injection, i had a few days of pain relief and thought I was improving during the injection . However, I have had the hot flashes, heart palpitations, insomnia, feeling of inability to breathe, and stomach nauseous since the shot(comes and goes). !I was told if the shots don t work, I will need to get the disks fixed. I am 40 years old, my mother had the same problem and had the surgery when she was in her late 40 s. The pain in the neck has returned and I don t feel any relieve. My question s in regards to the shots and hit should do. Is The reaction to the steroid normal, or can it be indicative of an unhealthy issues. Is the reaction to be worse if iget a second injection? I don t want to go through this reaction to the shots again if the best thing is to get surgery anyway, but I am scared for surgery. The reaction to the injection did scare me s well

doctor1 MD

I had a microdisectomy at L4/L5 in 2004. On the 14th of December I had a major flare up and could not put my left leg on the ground due to the unbearable pain. I was hospitalised and on the 21st December I had a nerve block as the mri showed extensive bulging at L5/S1. The nerve block did not work. I had an epidural on the 21st January which again did not work. Last Tuesday I was again taken in for a top up epidural which so far has not made any difference. I have been from wheelchair to bed since the 14th December. Is there any chance that the epidural injections could still kick in or should they have worked by now.

doctor1 MD

how should a person be treated who has osteomyelitis in their system and is diabetic and has a big place on there leg like a boil and was told by a doctor that it is already infected and shouldn't be lanced. this person has a very bad heart and...

doctor1 MD

Hi my name is XXXXXXX i am 58 yrs.old i have been scheduled for blatter surgery 2 remove a golf ball size stone.I have never been put 2 sleep before and suffer from terrible anxiety .I take 1mg zanax ever day and have for over 10 yrs. for panic...

doctor1 MD

Hi i just did a test for creatinine and urea because 5 days back i went through an arthroscopy and regional anesthesia and since then ive been having very clear urine, frequent need to urinate, feeling nauseous, loss of appetite, constipated and...