Reversability: Heparin vs Lovenox...someone asked me this a few weeks back

[cpatow]

I can't remember who asked me this question, but I now have the answer....

I just got back from my high-risk OB appt and they have switched me to Heparin (Low-Molecular Weight, I believe) because it IS reversible should I go into labor unexpectadly, whereas Lovenox is not. I can't remember the reversal med, but it exists so that should I require an emergency c-section, they would give me this shot and send me on my way.

The gal that asked me the question wanted to know about risks of c-section while being anti-coagulated. So, the first risk, acc'd to my doc today, is from epidural injection site and risk of hemmorage if you're on an anticoagulant. You can by-pass that risk by going under general anesthesia, but then you still have the risk of bleeds and hematoma or hemmorage or even clots from the c-section site. The best way, acc'd to my doc, to navigate this is to go on Heparin instead of Lovenox because your anticoagulant dose can be counteracted, thus reducing alot of the risk of anti-coagulant-based bleeding at the c-section site. And the side-benefit is that if I go into labor unexpectadly I won't have to be put under general and an epidural should be fine.

I'm so sorry I can't remember who asked me this!! I know she wasn't pregnant yet but this was a concern to her. Hopefully you see this or rec'd similar info from your own OB

Happy preggo-ing
Christina

[mommyofxyxyxx]

yep, you're right. In my pregnancies, I've been on lovenox up until the last month, then they switch to heparin twice daily because it gets out of your system faster and when you go into labor they can test your clotting(which is fun, you get pricked every thirty seconds)..and if you need the reversal drug (I didn't), then you can get it and get yourself an epidural..woooohoo...

[cpatow]

Well I JUST picked up my Heparin Rx yesterday. I did hear about a recall eons ago (well eons in pregnancy speak) and it was certain batches but I hadn't heard that about Heparin now. Yikes...will need to investigate.

Lovenox, from what I understand, is perfectly safe and fine and is a newer medicine than Heparin. The issue is that when you get closer to c-section time Lovenox can't be reversed whereas Heparin can. So they'll tell you to stop taking Lovenox 24 hours prior to c-section and if not, as there is a risk to hemorrage with an epidural, if you do need an emergency c-section or a c-section before the 24-hour timeframe of being off Lovenox, they advised me that I'd be put under general anesthesia.

My doc chose Heparin for me in my final weeks so he'd have more control over the situation also because if Lovenox is still in your system he told me there's also more risk of bleeds, hematomas and hemorrage at the c-section site. My other doc, though, seemed fine with the c-section risk of Lovenox so who knows.

Bottom line for me is I've been on both and personally felt more comfortable in my final weeks being on a med that was reversible so I could be awake during the surgery...I don't want to miss my little guy being born if I can help it.  But it's probably a very individual scenario so talk to your doc.

[alikat1205]

my doctor said heparin has been recalled, and so he put me on lovenox today -- what are the risks with that?  i know i will have a c/s since I have had a prior uterine rupture.

[cpatow]

I'd suggest asking your doc or pharmacist...totally wouldn't want to steer you wrong there...however prenatals haven't been an issue for me.

[Cheyenne_08]

Another quick question for you, were over the counter prenatal vitamins okay for you??? I wont know for another few days, but I am worried that I might be pregnant but it is too early to test. So, I wanted to get on prenatal vitamins ASAP just in case.

[nursekim]

Protamine sulfate is the reversal for the heparin.

[cpatow]

I'd really recommend two things: 1) talk to a HIGH-RISK OB and 2) talk to a hematologist. Obviosly this is specific to ME and your situation could be different, but as far as reversing Heparin it seems to be do-able.

BEST OF LUCK!

[Cheyenne_08]

Thanks for answering this question!!! That makes me feel a lot better about having another baby!!!! I talked to my own OBGYN and she didn't really say what she would do for me so I am glad you told me that.

[1nana]

Christina, it was cheyenne_08 who was requesting this info. I told her to check out your post.