Induction been offered as Im on clexane following a DVT

[maggie75]

Ive been offered the option of induction at full term and I dont know whether to take it. I am on a high dose of a drug called clexane as I have a history of DVT and also had one at 9 weeks in this pregnancy.

By inducing me, they could take me off the clexane in good time and potentially avoid excess bleeding which being on this drug can cause.

I can only have an epidural 24 hours after my last dose as well - so induction would clear the eay for an epidural at any time.

Any views on induction welcome and anyone else who has given birth on clexane?

[Pollyanna]

I have given birth 4 times on clexane (dvt in first pregnancy). I have never been induced at full term, but have always been threatened with it after about a week past my due date. Can you suggest waiting a few days past your due date?

I was also originally told I couldn't have an epidural, but I was on a different drug then, I think it is ok with clexane to have an epidural if, say, you inject in the morning, and go into labour in the afternoon.

[Katsma]

I was on clexane through my pg with DD who's now a year old (I have a history of DVT and PE)

I assume you are on a higher dose than I was, as mine was to prevent DVT, whereas yours is prevention AND treatment of DVT. I was told that I could have an epidural, but not within 12hrs of the injection.

As it turned out, went into natural labour, got nowhere for 13hrs, had emerg c/s using epidural. (Had placental abruption, but that's another story!)

There's others currently posting who are pg and on clexane. I'm sure they'll be along soon - very helpful crowd

There are also other clexane threads around (though I'm not sure there's anything particularly relating to induction) Search threads for clexane and heparin.

[Lulumama]

i would not agree to any induction at full term unless my bishops score was good

www.mother-care.ca/bishop.htm

or you could have a long induction and more chance of c.section at the end of it

my sister gave birth , early!, on clexane.

is this your first baby? there are lots of other options to deal with the pain before you need to have an epidural....

[lisad123]

hi maggie

I was offered induction for the same reason. I was meant to be induced on 4th oct but dd was in too much of a hurry to get here

I couldnt understand why they had said i would be fine to stop my clexane in the morning if i had any idea i might go into labour, but then changed and said oh we will induce you.

I hadnt had my clexane the morning i gave birth as i woke in labour at 6am, but it came very quick and i had no idea.
My sister is also on clexane ( we both have protein S def) and managed to not take her clexane the day she gave birth so was fine.

Its up to you, do you think you would want an Epidural? do you have any other problems that might result in C section? I would very tempted to wait and see how you feel closer to the time. Is it your 1st? if not how quick were your other children born?

Good luck
L

[toadstool]

Hi Maggie, I am on 40mg daily of clexane and the consultant said that an epidural could be considered within 12 hours of taking it if I had a clotting test done, and the result was OK. However in the end I had a very short labour, no need for pain relief, and had had enough early labour signs to skip the jab that evening, so it might well work out OK. As lulumama says, there's plenty of options beside epidurals (which don't always work btw).

[maggie75]

Thanks for all your comments. It is my first baby, so have no other labours to compare to Im afraid and Im on 70mg BD - so quite hefty dose. Im inclined to turn down the induction and wait for nature as you suggest - Im not keen on having an epidural unless absolutely necessary and have ordered a TENS machine, am stocking up on lavender oil, practising on my birthing ball etc etc etc! Have heard from several people about having a failed induction resulting in a c-section and dont fancy that at all.

[scruffymomma]

Hello ladies

Just starting my Clexane research as have just been diagnosed with DVT at 24 weeks.

My dose seems really high compared to you guys - I'm on 70mg TWICE a day, does this seem normal?

I'm getting lots of different opinions from various consultants ranging from - you can have a regular delivery to you'll have to have a c sec under general....

Something that's been mentioned is being moved on to Heparin nearer the time, which, as far as I can understand, comes out of your system faster than Clexane (I may have misunderstood)

Has this been mentioned as an option? I'm keen to keep my options of epidural open just in case a c sec becomes necc - I'd MUCH rather be awake if poss.

Hope that doesn't confuse the situation and I'd be really interested to know how you get on, good luck!

xx

[weeglenny]

Hi Scruffymomma
I'd been on 40mg of Clexane once a day when I was pregnant as a preventative dose for a previous DVT , but think that Clexane is just a type of Heparin - perhaps ask your doctor to confirm that? I'm not sure what the best recommendation is for you as you're on a much higher dose than I was, but FWIW I was going to be induced but went into labour naturally, although had an epidural and forceps delivery (another story). HTH

[dianedyer]

hello

i have recently been diagnoced with multiPle Pe P(blood clots in the lung P) and am on 60mg clexane twice a day , this is my 4th Pregnancy and was very scared as none of doctors gave me much information so ive had to search through many threads as far as im aware you can have a natural bith but there is a risk of hemmorge so you will be monitered very carefully also read that you have to have a c-section under general which i would not like thats if things dont go to Plan i was also told that i would continue the clexane for 2 months after delivery and the would go on to warferin for 6 months is there any mums out there that have had similer exPeriances as i would love to know more ive had 2 good deliverys and 1 very scary emergancy c-section and would like to know more about the delivery Please hoPe you all have quick uncomPlicated labours
diane xx

[notsoteenagemum]

I had PE at 34 weeks with DD now 8 and was on 70mg clexane twice daily, no mention of induction or section, just to go in at any sign of labour and not to have injection if in doubt.
DD was born naturally didn't need an epidural all was well, started taking warferin day after and continued for about 6 months and went on to have low dose clexane during subsequent pregnancy. Good luck.

[SnoopDog]

i was on similar and after a long chat to the anetheastist (sp?) it is 12 hours that is prefered as if your platelet count is too low and you need a spinal it is not possible and you may have to have a general worst case,

asprin is prefered 5 days as it takes longer to get out your system,

good luck with the baby

dd is 13 weeks now and doing fab

[RambleOn]

diane - Poor you. I've had a PE and it was agony.

I am 26wks into my second heparin pregnancy (I appear earlier in this thread as Katsma).

They are telling me the same thing again this time, that an epidural is ok as long as 12hrs have elapsed since last injecting.

I am on tinzaparin this time, at a very high dose, as I had another DVT after my DD was born, just after I came off the warfarin.

This time around the consultant obs is hinting that he'd like me to have an elective c/s. I think though, that it's because of multiple risks rather than just the heparin. ie. previous abruption, DD was low birth weight for gestation, maternal age 39.

Do you have Anti Xa blood tests taken? This measures the effect of heparin in your bloodstream. I am wondering if it would be poss to have one taken in labour to see if it would be safe for an epidural iyswim. I will ask him next time I see him.

[maxbear]

Prevention dose is 40mg once a day for most people, treatment dose is likely to be titrated to how much you weigh and usually much higher. You want to try and avoid a caesarean if you have had a dvt as this increases your risks of having another one so imo it would be worth avoiding an induction unless there were other good reasons for one.

[RambleOn]

maxbear - you sound knowledgable! Do you happen to know how my dose compares?:

Was on 40mg clexane last time. This time am on Tinzaparin 10,000iu. Different units of measurement, think it stands for international units.