blood clots in pregnancy

Blood Clots in Pregnancy and Other Bleeding Disorders

Blood clots in pregnancy as it does normally, although there are other factors that play a part that can lead to problems for both mother and baby if not treated in time. The blood is designed to clot when needed in order to stem bleeding from injuries, internal and external. It also has to remain liquid to facilitate the transport of nutrients throughout the body. Blood clots when special cells called platelets and a sticky protein called fibrin mix. Bleeding and clotting are normal body processes but disorders of the blood such as thrombophilia result in excessive blood clots in pregnancy. This can cause problems with the functioning of the placenta and also lead to deep vein thrombosis. Insufficient clotting can lead to bleeding beyond what is necessary and can cause a dangerous situation prior to and during childbirth.



blood clots in pregnancyExcess Blood Clotting in Pregnancy


The blood of the mother tends to clot more during and after pregnancy. At this time there is a greater chance of developing deep vein thrombosis especially following a caesarean section. There is also a danger of DVT associated with pregnancy and air travel, and spending long periods in bed due to illness.


Blood clotting disorders can be genetically inherited, such as factor V Leiden, homocysteinaemia, protein C and S. Certain autoimmune disorders can also cause problems such as antiphospholipid syndrome and lupus.


Blood Clotting and Embryo Development


Once the embryo attaches itself to the uterus there is a connection between the mother’s blood vessels and the placental cells. Thrombophilia can inhibit the flow of blood to the embryo because as the blood clots it also thickens. This can happen at any stage during pregnancy. If it goes undiagnosed it can lead to miscarriage, deep vein thrombosis, pre-eclampsia, placental abruption, intrauterine growth restriction (IAGR) and in extreme cases, stillbirth.


It is important that if there is a family history of these conditions that you seek medical advice. A blood test can reveal the presence of Thrombophilia and treatment can be given that greatly reduces the risk of harm to your baby.


Treatment


If you have experienced miscarriage and foetal loss, treatment for bloodclotting disorders should begin soon after you conceive. Today, Thrombophilia is not necessarily a barrier to a healthy pregnancy as treatments have improved over the last decade. These are some of the methods used:


  • The use of aspirin is usually the safest option throughout pregnancy.
  • If you need a more powerful remedy then Heparin can be administered for extremely severe cases of Thrombophilia. It is given by injection and one of its benefits is that it does not transfer to your baby via the placenta. One of its downsides is that it can lead to osteoporosis if used long-term.
  • The birth control pill can have adverse side effects for Thrombophilia sufferers.
  • Warfarin which is commonly prescribed as a blood thinner should not be used during pregnancy as it can lead to foetal abnormalities.
  • If you are undergoing a caesarean section then aspirin and heparin should be used.


Blood Clots, Pregnancy and Bleeding Disorders


Bleeding disorders can be passed down from generation to generation. There are 12 clotting factors in the coagulation system and if one is deficient it can lead to unstemmed blood flow. Spontaneous bleeding can occur in people that have a severe form of this abnormality. Many people do not know that they have this inherited deficiency until they undergo surgery or suffer injuries. The inability to stop bleeding is due to the deficiency in one of the clotting factors.


Severe pre-eclampsia can also lead to excessive bleeding. If there has been a placental abruption this can cause problems clotting as the mother’s supply of clotting factors has been exhausted. In these cases a blood transfusion will normally be needed. After the mother has recovered some strength, the deficiency in clotting factors will be made up by her liver.


Vitamin K deficiency in babies following birth, especially premature babies, can result in a deficiency of clotting factors. The condition is rectified by administering vitamin K supplements.


Thrombocytopaenia


This is a very rare condition affecting less than 1 in 4000 babies. It is caused by a deficiency or a an absence of platelet’s in the blood and can lead to bleeding into the nose, ears, mouth and skin. It can be caused by infection, where great strain is put on the blood to supply platelet’s faster than they can be replaced. It is possible for the mother to pass an antibody to the baby which can act against the platelet’s. Luckily there are treatments for this complaint.


Haemophilia


Haemophilia occurs due to a low count of the clotting factor VIII, and is usually passed on from mothers to sons. It is extremely rare in females, the mother’s acting as carriers and not sufferers of the disease. Even though it is passed down this way, more than half of the new cases diagnosed every year occur as a result of a spontaneous mutation in families with no history of the ailment.


Haemophilia can cause bruises and excessive bleeding from the nose, the joints and under the skin. Blood may be present in the stools as bleeding can also occur in the bowel. In rarer cases there can be bleeding into the brain. Haemophiliac babies can suffer from severe and strange bruising which gives them the appearance of being abused.


Prior to the introduction of blood screening, many haemophiliacs were infected with HIV and hepatitis B and C. Nowadays the screening is strict and there are much safer replacement products available other than blood to increase clotting potential.


Von Willebrand’s Disease


This is a genetically inherited disease that is passed from mother to baby. It does not seem to affect newborn babies but as they age they are more susceptible to bruising. About 2% of the population suffer from it although it is not always identified. It is most apparent when later in life the person undergoes surgery and it comes to the notice of medical professionals. There are more severe forms that can cause bleeding in the internal organs or from the mouth. Treatment is available to make up for the deficiency in clotting factors.


Other Clotting Factors


Factor five blood disorder, along with factor 10 or 11 and 12, have definite geographical boundaries. Certain countries have higher incidences of factors 10 or 11 and 12, such as the United Kingdom. The symptoms can be mild and often go undiagnosed until circumstances present an opportunity for a doctor to observe the body when cut. One more obvious symptom is excessive bruising. Treatment is available for all types of this disorder.