Any Heparin,Clexane ladies out there?

[Bearslikehoneyintheirtummy]

Hi ladies,I am 16 weeks pregnant and have been to see consultant today, he has put me on 40mg of clexane as he said he would prefer to err on the side of caution. This will be followed up by the Haemotologist soon.

I had a previous DVT about 3-4 months after the birth of my first child which was in 2009. Been tested for ANA antibodies too which came back + - and borderline last year, so I think he wants to test again for that. Can ANA tests be done in pregnancy though and if on Clexane?

I just wondered if this means if I will need to be induced (we didnt talk about that bit) What usually happens?

I'm on 60mg daily of clexane as I have APS and had bi lateral PE's in my last pregnancy. I went into labour then spontaneously while on 80mg twice daily of clexane and had had my last injection the night before and had a normal labour and delivery, although couldn't have an epidural.

I have been told this time that the clexane won't impact the delivery if I have had my last dose 12 hours or more prior to labour. If they induce me I am to do my last injection the day before induction, if I go into labour naturally, just obviously stop injecting when I do.

No advice, but interested to find out your experiences.

I've never been pg but have been recently told that I in all probability have Hughes' Syndrome (My mum has it and had 4 stillbirths and multiple MCs and I developed a blood clot on the brain last year). I've been told I can't have a full dx as my blood test results fluctuate (Hughes' can come and go) but that when I do decide to have children I will have to take Heparin for 3 months before TTC and throught pg.

Hi again Midori - its a small mumsnet! Do you know if the APS was the cause of you loss last time? Did you go into labour early or term?

Whiter sorry what you mean dx? (pregnancy brain here!!)Diagnosis?
When you go for blood tests are you like me then - sometimes positive sometimes negative? Mine was high for lupus anticiagulant. I would be interested to know more about you too as they don't seem sure whether to diagnose you or not, Is that how you see it? Are you still having tests?
Do you have any other symptoms of Hughes?

Hi there
I had a big PE at 33 weeks with dc2. Went onto clexane at 80 twice per day which went to 120 once per day after baby born. Yes, I was induced (at 39 weeks) as they wanted me to stop the clexane for birth (heavy anticoagulation not optimal in a bleeding situation!). I started the clexane again the next day (that is why I stayed on clexane rather than warfarin - as it doesn't come through the breast milk) and it was fine for the next 5 months ish?

hope that helps!

Thanks 51 weeks. Midori ad 51 did you have any symptoms before your PE ? Leg pain etc? .................and do they know where the clot started?
I am so glad I had symptoms in my leg before it progressed to a PE - must be very scary. So going by your dosage I assume 40 is pretty low? 9although the ob said the haemo may put that up or down)
Midori were you actually on Clexane when you had your PEs?

Hi I am on 40mg of Clexane as I have 2 blood clotting disorders. I've not ever had a PE or even miscarriage as I am one of the 'lucky' ones who was tested because of a family history of clotting. From what I have deduced 40mg is the lowest dose but I could be wrong! And as above you can't have an epidural within 12 hours etc. Plus I was induced last time as, due to the extra growth scans towards the end of pregnancy, they decided that my placenta was clotting too soon and so was induced just passed 37 weeks and delivered at 38+0.

A word of warning though, it's a painful drug! Take your time when pushing it in. I really, really hate it but I know it's for the best and how lucky I am that I've never miscarried or had any DVTs etc.

Hi Mumof thankyou. I know it is pretty nasty but I guess you get used to it. When I started doing it myself last time I hated it and would get only through half the syringe then take it out again. :( Then the hideous bruises - do you get them? I bet your tummy looks like a warzone by the end of pregnancy?! Did you have the extra scans because of your clotting disorders? Good job they caught the placenta clotting too soon x

Still not used it! And that's at 19+4 with my second! Think I'm just a wimp though..! I inject in my thighs as I am too skinny for my tummy and too scared about putting the needle near the baby. But my legs do look awful! It's weird though, sometimes no bruising at all and sometimes a massive one and I can't tell what I'm doing differently! Don't put ANY pressure on it afterwards though, that is a certain bruise! Hope you get on ok with it x

I have fat on my tummy so will be doing it there(quite a bit of fat!) You are not a whimp (I havent yet done my first dose today!!) It does sting doesnt it and its a full on injection so I think we are all very brave!! I remember trying to put it off for as long as I could in the day last time. :( When I tell other people they all pull a nasty face!!

It is, I'm not stalking you, honestly...

I don't know if APS causes the loss of my twin pregnancy, but I had early miscarriages both before and after that, prior to this current pregnancy. I probably wouldn't have been tested if I hadn't had the PE's though. My twin pregnancy was complicated. My waters went at 14+5 and I was then on bedrest except to attend hospital appointments. I went into labour due to choriamnionitis (huge and serious infection in the ruptured bag of waters) at 23+5, but had obviously had the infection symptomless for several weeks, so that probably contributed to the PE's aswell, as I got the PE's at 21 weeks.

I didn't have any symptoms of a DVT or similar, no leg pain whatsoever, although they have told me the clots must have originated in my groin or leg. However, even when I got the PE's and was horrendously out of breath, I was still insisting to DH that I was bound to get out of breath as I wa spregnant with twins and I didn't need to go to hospital and not to make a fuss. It was only as the midwife suggested I go and get checked that I felt I had to. My SATS were 80-85 when I was admitted and on oxygen, so 'out of breath' is probably an understatement...

I do find the clexane painful, sometimes more than others, not least as when I started it I still has bruises from the last time. It's also harder to inject as I get more pregnant and I am having to go round the sides of my stomach now, which does hurt more. I preferred to use my thighs, but I am on insulin 4 times a day and use my thighs for that, so can't really use them for the clexane too. However, I might swap as the insulin is less painful and much smaller needles than the clexane. I do have some fab bruises!

I don't mind if you want to stalk me anyway Midori - It would make me feel important! :)
How awful what you have been through with all this. Having a PE on its own must be traumatic enough but to go through all that. I feel so sorry reading about it. I pray this pregnancy goes well for you. I was wondering when you get further along because the skin must be a lot tighter around the tummy. Maybe I will try my thighs later on. Are you diabetic as well then?

Thankyou. Some people are much worse off than me though.

Tbh, the PE wasn't that bad, I was just so relieved at the time I didn't have an infection (although obviously I did, I just didn't know) I couldn't have cared less about myself.

I have gestational diabetes, so hopefully that will be gone once the baby is born, I could really do with a big slice of cake today!

Good luck with your pregnancy!

I have to have a blood glucose test too soon. I put on a lot of weight with my DD and never lost it afterwards so still carrying it. Apparently my BMI is 32 now so I think they test if you are over a level or have other risk factors?

I have just had a BIG slice of cake - sorry

Don't be sorry, make the most of it before your test. I am currently eating a scoop of Hagen Daz Strawberry Cheesecake ice cream. I don't have it too often, as it's not healthy, but as long as I keep within my carb allowance I can have it and still keep my blood sugar within what it's supposed to be. Since I was diagnosed and had to diet adjust (6 1/2 weeks ago) I have only gained 300g, so I must have actually lost weight, which I'm pleased about.

My BMI was 30 at booking but my previous babies have also been big, the biggest was DS2 who was 10lb when born at 38 weeks, so I had a couple of risk factors. I still expected it to be negative though.

Hello,

Just thought I'd add to this. I have protein S deficiency which I have known about for about 10 years. I was always told when I fell pregnant that I would be monitored and probably be put on clexane. Fast forward 8 years and I had a mmc at 12 wks (not on clexane, although I had spoken to doc and consultant about what my previous hospital had told me, neither thought it was necessary). Then last year I had my second mc at 7 weeks. It was frustrating knowing that I knew that clexane would probably help (I had brought it up again, but hadn't got as far as being referred to a consultant).

After my 2nd mc I was referred to a specialist who concluded that yes I needed to be on clexane. I am now 14 weeks and 2 days and have been injecting 40mg of clexane for 10 weeks. It was sore to begin with and the bruises were bad but as time has gone on I've just got used to it. Fingers crossed if this means I can have a baby that I long for then I would walk on hot coals.

My mw said that I would probably stop taking clexane at 36 weeks, however, when I met the consultant I was told that I would be induced early and they would tell me when to stop taking it and the day I stopped taking it would be the day before I went in to have the baby. I think it is to do with the epidural and pain relief and obviously blood loss/clotting.

Basically, I am just going to do exactly what I am told to :). It makes me totally paranoid though.

FX for everyone :) x

wow 10lbs. My daughter was only 7.3lbs last time so hopefully the next will be of similar size!!

Thanks pips, Yes I was thinking the same util I saw a consultant today. I knew I was at a higher risk again because of pregnancy but my Dr didnt say anything about me going on heparin at my booking appt.
Luckily for me I have only had one m/c at 12 weeks a few years back but that was only because I contracted malaria in Africa at the time - not any other reason.
It really is sad though that women have to suffer through even one m/c to get to this stage. I hope it all goes well this time for you - are you being seenby a consultant on a regular basis?
I don't know if it might help you relax a little if you got a heart dopple - I know it helped me relax a little last time but then the HB can be difficult to find and it can be a bit frustrating at first.

I had a long labour last time and had an epidural half way through, I would like to have it available just in case this time too. x

Hi earslikehoneyintheirtummy Yes no diagnosis. Like you I sometimes test positive and sometimes negative, apparently this is very common.

However, due to strong family history and the fact that I have had a clot: Last year I banged my head on a rail on the bus, felt fine at first until a few hours later when I felt faint and tingly, I then lost feeling down one side of my body and began slurring really badly. I was told I?d had a stroke but later found it to be a small clot that naturally dispersed, although I couldn?t speak for 6 weeks.

Generally my health is quite good although I do have Raynauld?s syndrome (very cold hands and feet) and suffer from migraines as well as generally always seeming to pick up a cold etc. Due to all this my records all say they are treating me as if I have it although they can?t officially say I do with inconclusive blood test results.

I?ve been advised that I?m fine to be un-medicated for the time being although, when/if I get pregnant I?ve been told that I would be unlikely to carry successfully to full term as it commonly goes into an active period during pregnancy (my mum?s stillbirths have been attributed to developing clots in the placenta). Therefore I should take Heparin for 3 months before TTC and during pregnancy.

Hope this helps and that everything goes well for you.

I take it heparin is safe in pregnancy?

The reason i ask is because I'm being treated for suspected DVT (24 hours after coming back form the Caribbean) and then 3 days later I was confirmed pregnant!

Having a doppler scan on my leg today at midday and hoping it is negative. My D-dimmer test came back negative so it's looking likely I don't have one but have had heparin now for 7 days.

Yes, it is absolutely safe in pregnancy. It is often used in conjunction with low dose asprin to prevent miscarriage or in women who have had unexplained recurrent miscarriages.

That's good news! I have a constant fear of MC mainly because I was taking Norethisterone for 7 days when I was actually in the very beginnings of pregnancy (despite a test three days before my period was due saying negative!) It was a week after stopping the Norethisterone that I found out that I was in fact pregnant. I took Norethisterone to stop a period.