Aa
Clexane during pregnancy
I made some genetic testing and the results are:
protrombin mutation heterozygote, MTHFR A1298C homozygote and B fibrinogen heterozygote. Factor V is normal. Antithrombin III normal. Antiphospholipide antibodies negative.
Now I`m 37 weeks pregnant and on therapy with Clexane 20 mg the last 2 weeks before that (until 30 week of pregnancy) I was taking baby aspirin. I have history of two miscarriages.
I want to ask you, should I take this medication till labor begins? After delivery should I continue with the therapy (for prevention of thrombosis)? What is your therapy in cases like mine - thrombophilia? Can you tell me what do you prescript from the begining till the end of the pregnancy with thrombophillia?
Thank you very much.
protrombin mutation heterozygote, MTHFR A1298C homozygote and B fibrinogen heterozygote. Factor V is normal. Antithrombin III normal. Antiphospholipide antibodies negative.
Now I`m 37 weeks pregnant and on therapy with Clexane 20 mg the last 2 weeks before that (until 30 week of pregnancy) I was taking baby aspirin. I have history of two miscarriages.
I want to ask you, should I take this medication till labor begins? After delivery should I continue with the therapy (for prevention of thrombosis)? What is your therapy in cases like mine - thrombophilia? Can you tell me what do you prescript from the begining till the end of the pregnancy with thrombophillia?
Thank you very much.
MEDICAL PROFESSIONAL
Hello,
There is some variety in how anticoagulants are used during pregnancy for women who have risk factors for clotting. Most women in this setting are being managed or have been consulted on by a high risk obstetrician which I am not (I am a general ob/gyn). That said, many of my MFM colleagues would argue in the absence of ever having a clot (if that indeed is the case) to continue a baby aspirin only. When Clexane (or enoxaprin, low molecular weight heparin) is initiated we usually switch women to unfractionated heparin at 36 weeks given the uncertaintly of the onset of labor in order to minimize the risk of excessive bleeding or make a spinal or epidural too risky.
In terms of the duration of use after delivery, this is usually guided by one's thromboembolic history (that is to say, if they have had a clot or not) and mode of delivery (cesarean vs. vaginal). In your case some might suggest you could stop after a vaginal delivery, others, more conservatively, may suggest to continue until six weeks postpartum, regardless of mode of delivery.
If you have concerns about how you are being managed I suggest you seek a formal second opinion.
Best regards,
Dr. Downing
There is some variety in how anticoagulants are used during pregnancy for women who have risk factors for clotting. Most women in this setting are being managed or have been consulted on by a high risk obstetrician which I am not (I am a general ob/gyn). That said, many of my MFM colleagues would argue in the absence of ever having a clot (if that indeed is the case) to continue a baby aspirin only. When Clexane (or enoxaprin, low molecular weight heparin) is initiated we usually switch women to unfractionated heparin at 36 weeks given the uncertaintly of the onset of labor in order to minimize the risk of excessive bleeding or make a spinal or epidural too risky.
In terms of the duration of use after delivery, this is usually guided by one's thromboembolic history (that is to say, if they have had a clot or not) and mode of delivery (cesarean vs. vaginal). In your case some might suggest you could stop after a vaginal delivery, others, more conservatively, may suggest to continue until six weeks postpartum, regardless of mode of delivery.
If you have concerns about how you are being managed I suggest you seek a formal second opinion.
Best regards,
Dr. Downing
I had my first IUI procedure on June 10. All my test came up great, HCG, Blood work, Clomid is working. I am very ansioux to know if it worked. My doctor said I had to wait 17-days after which will be June 26, if my mensus dont come then I just call and come in for a Blood PG test, very anxious and nervous. For the past 4-days I have charted my temp and its been the same 97.4, 97.6, 97.4 & 97.9 does that necessary mean anything? Is that a good for bad sign? Can anyone relate and give me some sort of advice, my doctor advised me not to take a PG test at home just wait for the blood.. THanks
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