DVT, Pregnancy & Holidays

[Mumtonone]

Hey newbie here!

Just coming up for 7 weeks pregnant, my first, and still feeling my way. Not due to see the midwife for another couple of weeks, but have been referred to a haematologist due to a previous DVT several years ago.

I know I'm likely to be treated as high risk, although not entirely sure what that means. I know I'll likely have to inject LMW heparin up to a few weeks before birth, but anything else likely to happen with a classification of high risk?

My immediate concern is getting a holiday before all the chaos kicks in - my life is manic as it is, and I only see things getting worse over the coming months . Not had a holiday in over a year (plus no days off work this year so far). Hoping to book over the next few weeks and tempted to go to the US, as it's a regular haunt.

Question is, is it safe to fly 8+ hours in the early stages of pregnancy with a prior DVT? I usually inject to fly long haul, but wondered with the pregnancy if I would just be told to avoid all together. Anyone had or heard of experiences of this?

[lozza22]

mumtonone, ile be interested on the replies to this post. Sorry i dont hav any advice but i am sort of in same situation. i am about 8ish weeks gone and have hol booked for three weeks away although shorter haul than you. I had surgery in march that was complicated by a massive heamatona that required further surgery and that then was followed by a suspected dvt. Was put on warfarin short term but once id recovered no more was said.
Im worried about how flying may affect me but i see mw on wed so all these things im going to ask about.
If i find out anything useful i will let u know but hopfully someone with more knowledge will post here too.

[rubyslippers]

i flew at 27 weeks

high risk pg because of DVT

it's possible but would discuss with your consultant

it was hard getting travel insurance and had to have a letter from doctor explaining why i had heparin syringes in my bag and that I was ok to fly

i wore flight socks, drank water, moved a lot and i was ok

[LittlePeaPod]

Hi Op,

You can fly right up to 28 weeks without MW letter for most airlines. i have done a bit of research as traveling abroad in September for our wedding and i will be 24 weeks. Its a long haul flight. been pregnant we are higher risk with regards DVT so agree with others that you should speak with your consultant.

In addition you need to speak to your travel insurer. Some of them don't like women travel before the 12 week mark and after the 32 week mark. Plus you need to discuss the previous DVT with them as it is classed as a material fact (Pre-existing medical condition). If you don't and need to claim for any medical reasons whilst abroad they would have every right to decline cover. I work in the industry so thought I should mention it.

[midori1999]

I have to be on LMW heparin during pregnancy due to previous pulmonary emboli and a clotting disorder and I got further PE's whilst on a preventative dose of heparin this pregnancy without flying, do I'd be extremely cautious about it. You definitely need to discuss with your haematologist.

I would also imagine they'd keep you on the heparin right up until labour and then post delivery too, as you are actually at higher risk of clots in the post natal period than in pregnancy. At least that has been my experience in 3 pregnancies on heparin and what I've been told.

[3littlefrogs]

Please don't contemplate flying until you are on clexane or similar.

You should discuss this with the haematologist, and definitely get going with the injections asap.

Do you know why you had the DVT?

Did you have thrombophilia screening after you were treated?

[3littlefrogs]

Midori - presumably you should be on a treatment dose of LMWH while pregnant?

Are you on long term warfarin with a high target when not pregnant?

That said - I have seen serious DVT/PE in pregnant women who have been on a coach trip for 4 hours. It isn't just flying that is risky.

Proper risk assessment is so important.

[midori1999]

I'm on a treatment dose now. I haven't been on warfarin so far as was TTC so they kept me off it and just on 75mg aspirin whilst TTC. I will be on warfarin permenantly once I've delivered though.

No long car journeys although probably just not as active as usual prior to getting the clots due to sickness, but I've got 4 other DC and dogs etc so I wasn't exactly doing nothing either.

[Mumtonone]

Hey guys, thanks of the replies to date.

My previous DVT has never really diagnosed. I was on the pill, then underwent laparoscopy surgery when I started getting pain, thought nothing of it and went on holiday (long haul flight) then after I came home pain started to get worse and my left leg turned completely blue. Cue DVT. Different doctors blame different things from the pill, to the op, to the flight - most likely a combination of all three.

I have no pre existing condition, and no reoccurrence despite going back on the pill again (switched to POP). I fly to the States pretty regularly and take LMW heparin to reduce the flight risk and always have the correct insurance coverages.

Could really do with a holiday though (full time stressful job, plus I care for my elderly Mum with Alzheimer's and Parkinson's disease who lives with us, plus pretty bad morning sickness). Just want some down time, before I really can't!?!

Don't see mid wife for another couple of weeks, and the ones I've spoken to seem pretty clueless re DVT. Since I've recently moved house I've had to switch doctors and get a new referral to haematologist, so don't have anyone to talk to re correct procedures and dos/don't during pregnancy.

Gaaah!

[3littlefrogs]

OP I am afraid midwives are not experts in DVT.

If you are pregnant, planning a long haul flight, and have had a previous DVT you really must have LMWH injections. Honestly, the risk is too great.

[JBrd]

Mumtonone You need to get your GP to refer you to a haematologist.
I had a DVT/pulmonary embolism last year, and when I found out I was pg, I immediately went to my GP, who arranged an urgent referral to the consultant. That was at just under 4 weeks pg, and I started the heparin injections immediately, I'm now 7+1 and only saw the mw for the first time today.

I would really consider a short haul flight instead, anything under 4 hours is (usually) OK. I will be flying to Vienna and Dublin later this year, and the midwife didn't have a problem with that when I told her.

Also, your DVT risk increases the further along you are in pregnancy, so if you do want to travel, it's probably better to do so sooner than later. My consultant told me that once I hit 20 weeks, I will probably have to increase the heparin dose due to increased metabolism when pg.

But you really need to discuss this with the consultant.

[3littlefrogs]

POP doesn't carry the same risk of DVT as the combined pill. Just mentioning that in the context of no recurrence.

If you are registered with a GP, it should be fairly straightforward to make an appointment, tell the doctor you are pregnant and have a history of DVT. You do need an urgent referral to a haematologist.

Have a look at the "lifeblood" website. (Just google lifeblood).