DVT/Clexane- hospital stay?

[supercarlie]

Hi
I've just been diagnosed with a DVT at the weekend and now I'm self-administering Clexane.
Will I have to stay in hospital longer post delivery now?
Any info would be greatly appreciated.

Supercarlie

Hi.
I was self-administering too for 10 days post birth, as DVT suspected, but ended up being sciatica (ultrasound showed negative for dvt)
I was kept in for other complications, so not sure about your situation, but saw your post was unanswered & wanted you to know i am here.
Good luck,
x

I've been advised I'll be given Clexane to administer daily if I have another pregnancy. IIRC the consultant said it wouldn't have any bearing on whether or not we could have another homebirth, so I wouldn't imagine there would be any impact on discharge times after a hospital birth :)

I have to inject clexane everyday I am pregnant due to thrombophilia. I had an ELCS and was discharged 48 hours later.

Tangle a pregnant woman who is on Clexane is much more likely to have problems with bleeding after the birth, I am sure that you would be stronly advised to have the baby in hospital. If you have had a previous pe or dvt then I'm afraid it does make you high risk.

supercarlie if you have a normal birth with normal bleeding you would be able to go home fairly soon as you could continue self administering clexane for as long as is required.

Bugger :(

We haven't seen the haematologist yet, so no doubt all will be explained to us in great detail at that appointment.

Thanks for the heads up :)

Thanks for all this information everybody. I knew I'd be considered high risk for delivery and that I'll need to be induced.
Last time, I had a normal delivery with normal bleeding so fingers crossed. However, this pregnancy has been entirely different. As all I suffered from was mild morning sickness and heartburn in first pregnancy. This time I've had dreadful sickness, a broken ankle (non-weight bearing, hence the DVT) and PUPPP. Now the DVT but I know it could be so much worse!:)

Are you on a theraputic dose of clexane? (eg. twice daily?) If so, you may have to stay in for a few days.

I stayed in after I had my DT's. I was on 80mg clexane twice daily (as I had had bi lateral PE's). I stopped it when I went into labour and then had to build the dose back up again as they wre concerned about bleeding. So I started on 20mg twice daily the night of the birth, then went to 40mg 24 hours later, then 60mg 24 hours after that, then back onto the 80mg.

This time I am on 60mg once daily as a preventative and am not sure yet if I'll need to stay in post birth, but am hoping not.

I didnt want to read and run.

Usually women can go home and administer the clexane themselves. It can vary on trust to trust policy.

I would have thought having a homebirth if youa re on cleaxane at present is something you need to discuss with your Obs. You are not 'more likely' to bleed after birth as someone has suggested as clexane is discontinued coming upto birth. If you have ahd a previous PPH etc you may be adivsed against it though but just make sure you are well informed when you go and see him/her .

If the obs has suggested that it may not be a problem for future then fingers crosses

Good luck

Maybe I won't give up hope then :)

I have had a technical PPH - but it seemed to be from a vaginal tear rather than the placental site.

Clexane is being discussed as, although DD1 was very straightforward, investigation into the 4 losses I've had since then showed raised levels of lupus antibodies - no PE/DVT involved.

Just have to wait and see what they say. Its coming up fairly soon so if this threads still going I'll update with what they said :)

I have lupus/APS and as well as the previous PE's, that is why I am on clexane and I am also on asprin. I have been told I will stop the asprin at 37 weeks, but continue the clexane until labour and then resume it until 6 weeks after the birth.

Oh I really hope its not twice daily!

DH's said he'll do it if I really can't. But he commutes and is out the door before 6 quite often. That'll be a nice way to wake up...

I'm on once daily now. I was on twice daily for six months after the PE's in my previous pregnancy.

If it helps, I was a total wimp about injections/needles/blood tests. When they told me I would need to inject myself I never thought I'd be able to do it. However, I am used to it now and in the previous pregnancy when I was on twice daily I preferred to inject myself during hospital stays and it's not too bad tbh. The fluid going in actually stings/hurts more than the needle, but it's OK if you inject it slowly.

The dose and how many times daily depends on your weight and the reason for needing the clexane.

If you stop clexane when you are in early labour it may be that you have still had a dose in the recent past therefore you are slightly more likely to have a problem with bleeding.

Tangle, if you have raised levels of lupus antibodies I really can't see them recommending a home birth (admitedly I don't know much about this, but I know that it is not something normally associated with low risk pregnancies) Of course it is your choice entirely, but please look in to it and find out all the information before you make a choice. Keep us informed, I'll be interested to hear what they have to say.

I had no PE just DVT that was not discovered by Ortho consultant even though I asked him about the changes/reddening of skin. I asked him if it was anything to go and see my GP about but he said no. Less than two weeks later an Obstetrician took one look at it and diagnosed it clinically as DVT!! I reckon I had been like this for at least 8 weeks.
I now self-administer 80mg Clexane twice daily and have been told to continue for 6 weeks post partum and have to wear the fetching white stockings.
I'm going to see the Obstetrician tomorrow but have been told that they might look at an induction at 38 weeks which I'm not keen on as I was induced at 40+10 last time and it was uncomfortable.

Why do they want to induce you supercarlie? Surely that will increase your risk of a section which in turn increases your risk of another dvt? Make sure you stand your ground on that one.

What is PUPPP? Sorry to hear you have a broken ankle. I had one too when I gave birth to ds2 last march. I was also on clexane because of the DVT risk, but didn't develop DVT.

Your situation sounds more complicated than mine was (I "just" had the ankle to contend with) but I only spent one night in hospital and was sent home with more clexane to self administer. Stings like buggery, doesn't it!!

Hope you get some answers and it all goes smoothly for you.

I'm assuming that by inducing me they will be able to "manage" the delivery. I've to go back in four weeks and they'll check to see if my cervix is favourable and book me in the next week for an induction.

My biggest problem with the induction is that they start it in the ward late afternoon/evening which means your partner is sent away and you have to go through the whole night without somebody just being there for you and then they get allowed to come back just for the delivery in the morning. This is what happened to me last time.

Mawbroon- I take it you are named after the Sunday Post characters? PUPPP is a really itchy rash you get supposedly with your first baby (this is second) and seems to be an allergic reaction to male fetal DNA!! There is not really anything they can do for it apart from delivery so in a sense an induction may be a blessing- it does seem to be lessening though. It was this rash that made me ask about the rash on my ankle (DVT) so in a sense it may have saved my life- drama queen- eh!?

Hmm.

Well, they say that there is no identified increase of risk related to birth. The dose is so low that there seems to be no increased risk of PPH (although they recommend an actively managed 3rd stage). They'll advise stopping injections as soon as I think I'm in labour if I'm still on them (some women stop at about 36 weeks - but its an area that has very little research). The only way prophylactic clexane normally impacts on birth is that you can't have an epidural until 12 hours after your last injection.

They wouldn't bat an eyelid at waterbirth or using the home-from-home unit.

However, they'd strongly recommend against a homebirth because of the increased risk. Except they've just told me there is no increased risk. Which has left me feeling rather over what this risk is that becomes so dangerous at home, but that they can't identify or tell me about.

So I'm all a bit bemused really - if they'd hadn't been so convincing there wasn't an increase in risk in the first place I'd have found it far easier to accept the logic that HB was too dangerous. I think I need to do some more reading and digging...

Tangle
What dosage are you on?

I'm not at the moment - but I think they were talking about 40mg once a day. (They also said that whilst the levels of anticardiolipid antibodies were raised they weren't raised by much)

Are they recommending induction for you, supercarlie? Have they come up with a good argument for doing it yet? I'm drafting a letter to the consultant I saw to try and get some more info - if there's a good reason for going to hospital then so be it, but at the moment I really don't understand the rationale and that bugs me! Sounds like you're in a similar position. Fingers crossed the rest of your pregnancy is as straightforward as it can be :)

I self administered clexane throughout my last pregnancy because of lung clots after my ds's birth. I wasn't allowed a home birth and had to be induced with dd just to be sure i was in the right place at the right time (ds had been a very fast unplanned home birth). injecting was dreary but fine. I had absolutely dreaded induction but in the end they just broke my waters and then had a short and uncomplicated labour in the birthing pool. I had to stay in hospital afterwards for 24 hours "just in case". I posted at the time about clexane and you might find these old threads useful here and here

I injected myself through both pregnancies due to thrombophilia and previous DVT and PE. Both were natural births although I was monitored very closely during pregnancy and labour.

I had to continue with the injections for 6 weeks following the births. Had no ill effects from doing so although bruising seemed to last for ages.

Hi, am 38 weeks + 5 days, and am being induced on friday (39 weeks) due to a diagnosed groin DVT in early jan. I have been on twice daily 60mg Clexene injections since then. They said that they are inducing so they can monitor everything and then get me on warfarin instead of the clexene, as my leg blood flow is still very sluggish. I can let you know how it all goes and if i have to stay in any longer etc after the weekend if you like? x

Oooo, I just found this thread and seems like some of you ladies are further along than me so would love to hear your stories!!

I'm 20 weeks tomorrow and on 2 x 40mg daily. Not fully discussed birthing yet; one MW seemed fine about home birth although prob not keen on that myself. Another MW suggested induction at 38 weeks; consultant obs suggesting natural but just don't inject 'that day' and consultant haematologist something similar, so frankly who knows!!!