Complications postnatally

Deep Vein Thrombosis

This is when a blood clot forms in the deep vein of the calf, leg or pelvis. Women are more at risk of developing a blood clot during pregnancy and after having a baby and a caesarean section can further increase this risk.  Therefore it is essential to look out for possible symptoms.

Symptoms can include:

• A red, hot swollen leg
• Your entire leg being swollen or a feeling of heaviness
• Tenderness or pain in your leg which may only be felt when standing or walking 

A DVT can lead to a pulmonary embolism (PE), this is when the blood clot breaks off and travels to the lung. Although this is very rare it is life threatening.

Symptoms of a PE include:

• Sudden difficulty with breathing/shortness of breath
• Chest pain or a feeling of tightness in the chest
• Coughing up blood
• Feeling very unwell or collapsing

If you experience any symptoms of  DVT or PE you must ring triage, or 999. 

Certain factors can increase your risk of these conditions:

• If your BMI is over 30
• If you are aged 35 or older
• If someone in your family has had a DVT
• If you have heart disease, lung disease or arthritis
• If you have severe varicose veins
• If you are a smoker
• If you use intravenous drugs
• If you become severely dehydrated
• If you are in hospital (reduced mobilisation)
• If you lose a lot of blood at birth and needed a blood transfusion

After the birth of your baby your midwife will carry out a risk assessment for DVTs which take any of the above risk factors into account. If you are considered to be at intermediate risk then you will be offered a prescription of heparin injections to take. They will need to be given once a day for 10 days. You will be shown how to self administer these before going home and provided with a sharps box. If you are classed as high risk, 6 weeks of injections will be provided. 

Sepsis

This is a serious infection that can happen after birth, it can be life threatening and affects the vital organs. It is vital that treatment is given as soon as there is suspicion of sepsis.

Factors that can increase the risk of sepsis are:

• Being overweight
• Diabetes
• Pre existing medical conditions such as heart and lung disease
• Taking long term steroids
• If you have a weakened immune system
• If you have recently had treatment for cancer 

Events that can cause infection and potentially lead to sepsis are:

• If you been in contact with someone who has a Strep A infection
• If your waters broke early in pregnancy or were broken for longer than 24 hours
• If you have some placenta retained in your uterus after birth
• If you have had a pelvic infection diagnosed during the pregnancy
• If you have a urine infection
• If you have had a cervical stitch – a stitch inserted in your cervix to prevent pregnancy loss 

Symptoms and signs of sepsis can include:

• Severe shivering
• Muscle aches and pains
• Passing very little or no urine
• Slurred speech/disorientation/confusion
• Mottled or discoloured skin tone/rash
• Sore throat
• Abdominal pain/swelling
• Offensive smelling vaginal discharge
• Pain, redness and foul smelling discharge from wound site
• Hot and tender breasts
• Diarrhoea/vomiting
• Fresh new vaginal bleeding

If you have any of these signs/symptoms ring triage immediately.