cpatow, blood clot question

[Cheyenne_08]

Wannabenana on another forum told me to post my question here for you, and said you might be able to answer my question. I was on hospitalized bed rest for 3 weeks and had a c-section 9 months ago. Four weeks after my c-section, they found 9 blood clots in my right leg. I was treated with Lovinex injections every 12 hours for a week and then went on Coumadin for the next 3 months. I had low blood flow to the placenta and before it was all done, I had a lot of complications. Anyway, on to the question....I want another baby (not anytime in the near future but sometime) and I was wondering how a doctor might handle my situation?? Has anyone else on this forum had blood clots and then gotten pregnant again? How did your doctor handle it???? I already take 81 mg Aspirin every day and will have to for life.

[Cheyenne_08]

Thanks ladies!!! Blood clots are so scary!

[guatmommy]

I have a blood clotting disorder and have had a blood clot n my lung.  It was very tricky at firzst getting me on the right dose of lovenox.  I take it now once a day (injection) and I take a baby aspirin.  i am 7 1/2 mos and so far so good (well with tha)...lol...

[cpatow]

Hi there,
The appt went great (I'll update a separate post in a moment) and I did ask him about c-section risk and he said, "Oh PLEASE don't worry. The risk is so small of emergency c-section and of risks from being on Lovenox. Please on't worry about that."

We didn't go into detail about if they can counteract anti-coagulant but it seems to me that there would be since, for example, eating too much Vit K does exactly that.

I go in 2x a week now for non-stress test and bio-physical profile or something so I can always ask more questions!!

[Cheyenne_08]

How did your appointment go?

[Cheyenne_08]

When you ask your doctor, please let me know!!! I am very interested in all the possibilities before considering another pregnancy. I go to my OB/GYN on the 10th of April, and plan to talk with her about all of this and get her opinion. She did not handle my first pregnancy and so I wonder how she would handle it. But thank you for the information!!! Please update me on what your doctor tells you.

[cpatow]

Forgot to mention about that. If you go into labor unexpectadly and you haven't been off anti-coagulant for 24-hours then they put you under general anesthesia. The risk is more to do with giving an epidural because there is risk of hemorrage at the epidural site. I don't know about any meds to counteract the anti-coagulant and I'm sure that c-section would certainly impose a greater bleed risk, however, I remember during my last c-section the docs were SO careful and cauterized (if that is the proper term to use?) each and every single little bleed they saw...I think they were more over-cautious than I was at that time.

Nonetheless, that is a good question and I will ask my OB at my appt tomorrow

Chriistina

[Cheyenne_08]

Wow, that is one heck of a story! I had no underlying disorders and the clots were attributed to the bed rest and c-section. I had a minimum of 3 clots (they stopped looking after finding 3 in each vein so they said there could have been more) each of the three main veins down the back of your calf...I had no issues after that, and so I am glad you see you are doing okay with your pregnancy. My biggest fear is that there would be complications and I will have been on a blood thinner....for example...I went into labor at 29 weeks and then again 4 days later....if this was to happen the second time around, I would not have stopped taking the anti-coagulant 24 hours prior to the birth ( have to have c section because my incision is twice as long as most peoples). I ended up having an emergency c-section because the cord was around my son's neck 6 times. I am just so worried that somthing like that would happen again and here i would be, on a blood thinner!! Not to sound stupid, but do they have any meds that would counteract the heparin if you were to have complications and need a c-section immediatly??? I want more kids but I am scared to death something would happen and I would bleed to death! Has your OB addressed what would happen in an emergency.

[cpatow]

Hi!
I am pregnant, 32 weeks, 1 day and am doing JUST GREAT!!  I am 30mg Lovenox 2x/day (so every 12 hours) and have had no complications or signs that any other clots are brewing. My clot was near my groin in the iliac/femoral vein but I suspect it actually was higher up in the abdominal area but just not visible w/ standard ultrasound because of being pregnant. It was a HUGE clot that stretched all the way from my groin to my knee...one solid clot. Quite frankly it is a miracle that I didn't throw an embolism, have a stroke or heart attack and that I am alive with zero complications other than some residual leg swelling (but it's very manageable...heck even ran a marathon).

My clot was during my last pregnancy, I was hospitalized for one month and I had a c-section without incident. I always wanted another child after that but felt the risk was too high. Finally, about two years ago, we decided to talk to my high-risk OB and he really calmed us.

You should have had a battery of blood tests already to determine if your clot was caused from any issues besides bed rest and c-section, but I know that situation right there is a classic cause for clots. Presuming you have no underlying disorder causing the clots (and even then there are ways around the situation in many cases as women on this board can attest to)  they will likely just have you on Lovenox throughout your pregnancy. My high-risk OB now has told me that (FOR ME....) the risk of a repeat clot while anti-coagulated is <3%, maybe even less than that.

I started Lovenox at ~4-6 weeks at a lower dose and then increased to my current dose. I will stay on this until 24 hrs prior to c-section and then start back on it immediately afterwards and stay on some form of anti-coagulant (either that, Heparin or Coumadin) for probably some time afterwards. I was on anti-coagulants for ~2 years after my last c-section.

So, there you  have it. I'm not worried at all although I am definitely considered high-risk and now go in twice weekly for ultrasounds and baby-checks to insure overall health. Part of that is my age, too.

If and when you are ready for a 3rd, consult a GOOD high-risk OB or even a hematologist who can assess your overall situation and provide the proper guidance for you as each of our stories and treatments is SO unique. But for me it's been do-able and while everyone around me is freaking out (it was about this time that I was diagnosed in the last pregnancy) I just keep reminding them everything is fine and there is nothing to worry about :0)

Best of luck to you!
Christina