Women with blood clotting disorders - Page 21 - Mothering Forums

Women with blood clotting disorders

primipara's Avatar primipara
03:01 PM Liked: 0
#601 of 611
05-13-2011 | Posts: 73
Joined: Dec 2010

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.


sarahtar's Avatar sarahtar
03:59 PM Liked: 16
#602 of 611
05-13-2011 | Posts: 677
Joined: Mar 2004
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.
primipara's Avatar primipara
12:05 PM Liked: 0
#603 of 611
05-14-2011 | Posts: 73
Joined: Dec 2010

Thanks, that is really helpful. Stopping the Lovenox early seems like a good solution. 


wennerk's Avatar wennerk
06:13 PM Liked: 13
#604 of 611
05-15-2011 | Posts: 31
Joined: Aug 2009

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...

 


airmide_m's Avatar airmide_m
02:16 AM Liked: 11
#605 of 611
07-13-2011 | Posts: 859
Joined: May 2006

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!

 

 


jcwmama's Avatar jcwmama
07:25 PM Liked: 11
#606 of 611
09-11-2011 | Posts: 41
Joined: Sep 2009

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!


jcwmama's Avatar jcwmama
02:21 PM Liked: 11
#607 of 611
09-18-2011 | Posts: 41
Joined: Sep 2009

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!


nsmomtobe's Avatar nsmomtobe
10:02 AM Liked: 95
#608 of 611
03-06-2014 | Posts: 1,221
Joined: Aug 2009

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?


Redmom's Avatar Redmom
02:48 PM Liked: 27
#609 of 611
03-28-2014 | Posts: 192
Joined: Jul 2011

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 


nsmomtobe's Avatar nsmomtobe
06:33 AM Liked: 95
#610 of 611
03-30-2014 | Posts: 1,221
Joined: Aug 2009

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.


artemis80's Avatar artemis80
10:12 PM Liked: 10
#611 of 611
11-11-2014 | Posts: 885
Joined: Sep 2006
Hi ladies,

I remembered this thread from when I used to post on here back in the day, and I'm hoping someone or some of you are still posting.

When I was pregnant with DS back when I was 25-26, some members of my family tested positive for FVL. Because I was pregnant, I got tested as well. I found out I am hetero for FVL and compound hetero for MTHFR. They didn't have me do Lovenox during pregnancy back then, but postpartum, I did do Heparin for a few days and then Coumadin for six weeks. At the time, the perinatologist said it'd be best to be done having babies by 30. I had never, and still have never (knock on wood) had any clotting issues at all.

Well.... (what happened to all the old smilies?!!??) life has changed a lot, I'm 34, and wondering about having another baby. I'm assuming that because of declining fertility (already? sigh) and the blood clotting issues, I should do this sooner rather than later.

Without being too indelicate, how old are you all? Have you been told anything about getting pregnant in your 30s?

Do most doctors still want to induce? With DS, the peri I was consulting with told my CNM that "we like these patients to deliver by their due dates." It turned out not to be an issue, as he came a few days early. And I was only 26! Sheesh! I'm assuming any OB would now, since I'm older, have me do injections throughout pregnancy?

Thanks!

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