Concerns About Bleeding Disorders During Pregnancy
Greetings everyone! I’m a 38-year-old woman, standing at 5 feet 4 inches and maintaining a BMI of 24.5 with a stable weight around 60 kg. I have been diagnosed with Ehlers-Danlos syndrome type 3 and reside in the UK, receiving care through the NHS. Recently, I have begun evaluations for a suspected case of Crohn's disease. Currently, I am pregnant and classified as high-risk. I am not taking any form of medication and I also have lactose intolerance. I choose not to smoke, drink alcohol, or use drugs. In my younger years, I struggled with an eating disorder, primarily because eating was associated with painful bathroom experiences, leading me to eat very little. Today, I follow a healthy diet consisting of three meals and snacks, but I still endure significant discomfort. Throughout my life, I have always bruised easily and experienced frequent nosebleeds as a child. Fainting episodes were also common, but these were attributed to my vegetarian lifestyle back then. However, since I started eating meat and maintaining a balanced diet from the age of 22, these issues have persisted. Whenever I sustain a cut, I tend to bleed excessively and bruise with little cause. I used to think this was just a normal occurrence, but when I mentioned it to a GP, they dismissed it, especially since my more pressing bowel problems were overlooked until quite recently. Now, during my pregnancy, the bleeding has intensified, yet my clotting factors appear to be normal. This is puzzling to me. Is it possible that there exists a type of bleeding disorder which isn't identified through standard clotting factor tests provided by the NHS, and one that may worsen during pregnancy? Due to gestational diabetes and my tendency to have larger babies, I will need a cesarean section, but this concern has not been adequately discussed with me. Previously, I lost about five and a half pints of blood during childbirth, which raises my apprehension about facing a similar scenario again. I had always assumed my symptoms of bruising and bleeding were typical, believing that pregnancy exacerbated the problem. However, I've come to recognize that my experiences, such as lengthy episodes of bloody diarrhea and chronic constipation, are indeed not normal, irrespective of what medical professionals have suggested. They often blamed hormonal changes from menstruation, and when I disagreed, they tried to attribute it to anxiety, as if anxiety could cause bloody stools. I would appreciate any insights or comments on this matter. Thank you! ✨️
Answers (1)
3/28/2025, 8:30:55 AM
OpenHealth AI
It's understandable to have concerns about bleeding disorders during pregnancy, especially with your medical history and experiences of easy bruising and excessive bleeding. While your clotting factors may be normal based on standard tests, there are indeed bleeding disorders, such as von Willebrand disease, that might not always be detected through routine testing. Such conditions can become more pronounced during pregnancy due to hormonal changes affecting blood vessel integrity and clotting mechanisms.
Explanation:
Ehlers-Danlos syndrome (EDS), particularly the hypermobile type, can contribute to fragile blood vessels, leading to easy bruising and bleeding. Your history of frequent nosebleeds, excessive bleeding from cuts, and the significant blood loss during childbirth are concerning signs. It's crucial to recognize that not all bleeding disorders show up in standard clotting factor tests; some require specialized tests to diagnose. Additionally, hormonal fluctuations during pregnancy can exacerbate underlying conditions.
Next Steps:
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Document Symptoms: Keep a detailed diary of your bleeding episodes, including when they occur, their severity, and any triggers you notice (e.g., certain activities or foods). This information will be valuable during consultations.
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Seek Specialized Care: Contact a hematologist who specializes in bleeding disorders. Discuss your experiences and concerns, particularly regarding past blood loss during pregnancy and your ongoing symptoms. A referral through your GP may be necessary, so consider advocating for this.
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Discuss with Your Obstetrician: Bring up your bleeding concerns and previous childbirth experiences with your obstetrician. Ensure they are aware of your history so that they can develop a tailored plan for your delivery, including preparations for potential complications.
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Monitor Your Nutrition: Continue maintaining a healthy diet while managing your lactose intolerance. If you haven’t yet, consider consulting a registered dietitian who understands your medical history and can help optimize your nutrition during pregnancy.
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Stay Informed: Educate yourself about bleeding disorders in pregnancy. Reputable resources like the NHS website can provide valuable information. This knowledge will empower you to assertively discuss your care with healthcare providers.
It's essential to address these concerns with a supportive and open approach to ensure the best care for you and your baby. If you have any urgent symptoms, such as severe bleeding or signs of anemia, seek immediate medical attention. I'm here to help with any further questions or guidance you may need.
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