Women with blood clotting disorders - Page 21 - Mothering Forums

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#601 of 610 Old 05-13-2011, 02:01 PM
 
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Hi ladies! I am hoping to get some advice on a homebirth plan for those on blood thinners.


I am 9.5 weeks pregnant after 1 round of IVF, 2 FETs and 2 years total TTC. Naturally through infertility I had every test under the sun and they turned up a slightly elevated level of lipoprotein (a). As a result I was put on daily Lovenox shots from the first day of the transfer.  Now I have interviewed 5 homebirth midwives (out of 16 in my area) and the 2 that I liked the best, who seemed the most educated and responsible, were both very cautious to negative about doing a homebirth while I'm on Lovenox.

 

They both referred me to a homebirth friendly perinatologist for a second opinion. I am hoping that he says I don't need to be on it, but short of that, do you have any ideas for a homebirth plan that would reduce the potential risks, or about what to say to the midwives to convince them to work with me? I am happy to consult with an outside doctor and to have a backup plan, but at least trying for a homebirth is very important to me.

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#602 of 610 Old 05-13-2011, 02:59 PM
 
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Do you need to be on the Lovenox until you deliver? The MFM we consulted with during my last PG had floated the idea of blood thinners with me, then ultimately decided they wouldn't provide enough benefit (for me) to outweigh the risks, but while we were still deciding, I had asked about homebirth implications. Every midwife will be different, of course, but my midwife had made it clear that as long as I had been OFF blood thinners for 3 (I think it was 3) weeks prior to delivery, she was fine with that, and the MFM said that she wouldn't want me on blood thinners at that point, anyway.

So assuming that they would stop the thinners as you approach delivery, that helps to change the conversation with the MWs you talk to. Maybe they would feel more comfortable if you offered to have a blood draw to show that your blood counts were all normal before delivery?

I mean, I wouldn't want to do a homebirth while on blood thinners - hemorrhage is scary and pretty hard to successfully treat at home by a midwife.
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#603 of 610 Old 05-14-2011, 11:05 AM
 
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Thanks, that is really helpful. Stopping the Lovenox early seems like a good solution. 

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#604 of 610 Old 05-15-2011, 05:13 PM
 
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Hi primpara,

 

I don't know how Lovenox compares to Heparin, but I was on Heparin (for Factor V Leiden) all through my pregnancy and managed to do a successful homebirth while on it.  The doses are spaced 12 hours apart, so I was told by a perinatologist that as long as I didn't take a shot close to when I went into labor or until 12 hours after birth, I would be fine.  It ended up that I took my morning shot, went into labor in the late afternoon, and then didn't get my shot again until about 1pm the next day.  The midwife that attended my birth had never dealt with a woman on blood thinners before.  When I first interviewed her, she did some research on the subject and concluded that as long as DH and I felt comfortable managing the Heparin, she would leave it up to us.  That's just my two cents...

 

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#605 of 610 Old 07-13-2011, 01:16 AM
 
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After over 5 years and many different infertility treatments while TTC #1, I'm doing some intensive research into implantation failure due to auto immune issues and clotting factors. 

 

I was able to get a few tests, but mostly they're saying I need to have 3+ miscarriages to justify testing. But if they can't implant, I can't get to the point of a miscarriage (not that I'd ever want that either of course!). 

 

I did find three things elevated and I'm wondering if those may be cause for any concern, or justification for treatment with lovonox?  Fibrinogen 427 (range 150-400 mg/dl) and under Coag Study, Von Willebrand, Von Will Ag 162 (range 49-153%) and F VIIIC Act 138 (range 65-130%).

 

I'd also love to hear if/how anyone has been able to get testing for other disorders without having prior recurrent miscarriages? I have Hashimoto's hypothyroid and insulin resistance which I've read increase the chances of clotting disorders and associated implantation failure or miscarriage. I also have (possible TMI warning til the end of this paragraph) excruciatingly painful periods with heavy bleeding, clots and mid cycle spotting (I've had a laprscopy - no endometriosis). And when I was 19 I had a reaction to sulfa antibiotics which involved GI bleeding to the point that my stool was basically pure blood for the better part of a week, and the doctor seemed surprised when I came in for a follow up and wasn't dead. So I'd think some of those things might be some justification, but I don't know!

 

Thanks for any help or advice anyone can provide!

 

 

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#606 of 610 Old 09-11-2011, 06:25 PM
 
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Can anyone in the Roanoke oy Lynchburg area of Virginia advise on a good OB or midwife for a women with clotting disorders?  I'm currently 7w and on generic Lovenox once a day.  I'm not happy with my current OB and practice and looking for someone famaliar with clotting disorders.  Any information or suggestions on where to look would be greatly appreciated!


Mama to one sweet monkey born 07/07 and one perfect mouse born 04/12.

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#607 of 610 Old 09-18-2011, 01:21 PM
 
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Hi ladies- looking for a little advise.

I'm 8w and I have antiphosopolipid syndrome with anticardiolipin antibodies.  I'm on a once daily 40mg Lovenox injection and once a day 81mg aspirin.  I've miscarried 3 times before in the 7-9 week range. I made my first ultrasound with this pregnancy for 11 weeks because of all my negative experiences with ulrasounds around the 7-9 week time frame.  Now I'm wondering if I should go in for an ultrsound this week, around 8.5-9 weeks.  Can anyone let me know if they know of any reason this would be beneficial?  Is there something that could be seen on the ultrasound that could indicate that my dosage is incorrect and could be adjusted?  I don't want to wait until 11 just because of emotional reasons and then at 11 weeks the ultrasound show something that the OB says we could've fixed had we known earlier.  Does that make sense? 

I lay awake at night worrying about...well.. everything and I'm wondering if the u/s now would calm my nerves. 

If it helps, my number for the anticardiolipin antibody was 47 (though I can't remember the units right now) which the OB said was just inside what is considered 'treatable'.  Apparently 40+ units is treatable. 

Any advise would be most appreciated.  Thanks for your time!


Mama to one sweet monkey born 07/07 and one perfect mouse born 04/12.

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#608 of 610 Old 03-06-2014, 09:02 AM
 
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I know this thread is old, but there is a lot of wisdom contained here and I hope by resurrecting it, I can bring back some of the knowledgeable participants.

 

I got my blood work back yesterday after 3 miscarriages. Karyotype testing is pending, but as far as I know, that doesn't test for MTHFR, does it? It does not look like my Homocysteine levels were checked, but I'm not sure what that would look like. I know I was checked for Factor V Leiden, but I don't see those results either. I was tested for Antithrombin III, ANA, Protein S, and Protein C activity, as well as TSH and CBC.

 

According to my doctor, all of my blood work came back normal, so there is no obvious clotting disorder. However, she has suggested that I start taking baby aspirin anyway. She said it might help and it shouldn't hurt. Does this sound like a good idea to anyone? I've read somewhere that if you take baby aspirin, you should have your platelets monitored regularly.

 

I'm noticing that my platelet count is 201 (10e9/L), which is on the low side of the reference range (186-353) but my mean platelet volume is 12.3 fL, which is higher than the reference range (9.6-12). Does this mean anything in terms of clotting?

 

ETA: After reading through the thread and looking back at my results I notice now that I actually have a positive result for ANA: Anti-dsDNA is in the indeterminate range and anti-RNP is in the positive range (1.3). What does that mean? According to what I see, it might be systemic lupus erythematosus? Does that have anything to do with clotting?

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Cautiously expecting Dec 2014!

 12/08 (6 weeks),  1/13 (11 weeks), &  12/13 (9.5 weeks)
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#609 of 610 Old 03-28-2014, 01:48 PM
 
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I've had 2 m/c and had a panel of bloodwork for RPL (recurrent pregnancy loss).

I've tested positive for 2 copies (homozygous) of the 4G variant in the PAI-1 gene.

I'm just learning what this means, so far my understanding is that it is associated with miscarriage, also clots and heart attack.

My doctor (we are seeing an RE) said the management would be daily aspirin during my next pregnancy (hopefully this will happen) - but I've also read of women with blood clotting factors being daily shots of lovenox (or similar).

Does anyone have any experience or knowledge of this subject?

Thankyou 


40 y/o married Mama, 3 y/o DS, Angel Baby lost in Sep 2013, Angel Baby lost March 2014.
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#610 of 610 Old 03-30-2014, 05:33 AM
 
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Hi Redmom,

 

I have never heard of that gene before and I know little about blood clotting disorders (I just resurrected this thread in hopes of bringing in those with more experience) but I have started a thread for taking baby aspirin, which I hope you will find helpful: http://www.mothering.com/community/t/1398846/baby-aspirin

 

My RE mentioned that the ideal standard is to combine the aspirin with heparin injections, but she said that I did not qualify for the latter because I didn't have an obvious clotting disorder. If you do have an actual diagnosis, maybe you do qualify. You should ask your doctor about it when you get pregnant again.


Now mom to a boy born January 2010. 
Cautiously expecting Dec 2014!

 12/08 (6 weeks),  1/13 (11 weeks), &  12/13 (9.5 weeks)
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