Heparin users - please tell me urgently what you think? Thanks!!

[MrsMcJnr]

I live in Spain. I have factor II thrombophilia. I have just discovered that I am pregnant with my 3rd child (hopefully, I have MC twice). I am very excited but the timing is tricky as I go on holiday on Thursday and need a scan (or so I have always been led to believe in my previous pregnancies) before I can start injecting my heparin. Saw dr this morning and he said as I have no pain the baby won´t be ectopic (?!) and to just start the heparin. I am concerned about this advice. I´m somewhere between 4-6 wks pg. What do other people who take heparin/know about heparin think of this advice? Many, many thanks. I am trying other avenues to push for a scan first but I just wanted some advice from you ladies. Thank you.

Um. Not sure - but you could try taking 100mg aspirin instead? Or are you flying? If you're flying I'd take a heparin shot before flying there and back.

I didn't start heparin until week 16 of my pg, ditto my sister for both of hers (we have Factor V Leiden thrombophilia). But we haven't had any clots either - it may be different if you have had a clot (you don't say).

I don't honestly know what benefit the scan would have in terms of you starting/ not starting the heparin, but maybe someone else does.

Thanks for responding. I am taking aspirin too. Was with my losses too though so am advised to take heparin every day too from as early as possible until 6 weeks after the birth. The scan would show that the baby is in the right place and not ectopic, the reasoning I have been given before was that if the baby was ectopic and I took heparin I could bleed out very fast if it ruptured. I have no real idea of the risk of that though. I haven´t had any clots just and 2nd trimester MC and a recent earlier one. Yes, we are flying but only shorthaul, another good reason to start the injections!

Yes, I thought after I'd posted that the ectopic might be the reason for caution re. the heparin without a scan.
See if you can push for a scan - and have you spoken to an actual haematologist about this or was it an obstetrician? If you haven't spoken to a haematologist, push for that.

MrsMc I inject heparin daily in pregnancy. Was advised to do it only after scan at 6 weeks for the same reason as you, however I refused the scan until 7 weeks so we would know for certain one way or another.

Do you have time to seek a second opinion before you go? If not how long are you away for? If only for a week / ten days I would leave it until you come back then demand ask for scan. Ectopic is very rare, but those of us who have had second trimester miscarriage know even rare things can happen. It's a difficult one.

I can see no problem with delaying the heparin until 7/8 weeks pg but I would like to hear the likelihood of heparin causing probs with ectopic from an expert tbh.

I have Factor V Leiden and was told to start injecting Clexane from the day that I got my first positive HPT. Even when it was suspected that I was having an ectopic pregnancy (lots of v early scans and repeat HCG blood tests, levels slow to rise, unable to see anything on scan), I was told to continue. The only time they told me to stop was when they decided that the pregnancy was "most likely not viable" and I was sent home to "wait and see" for 2 weeks before my next scan. Thankfully my "not viable" pregnancy is now a very healthy 5 year old DD :). I can however see the link between possible ectopic and use of Heparin increasing risk of bleeding out, as I was also told to stop Aspirin in the run up to my due date for the same reason.

I was told to take Clexane from my BFP. (I have APS and have had clots in my lungs during pregnancy)

I can see why it would be a risk if you have an ectopic, but wonder how common a rupture of an ectopic would be early on and if you've had no symptoms of one or reason to suspect one? Perhaps they are just being very cautious?

Thank you all for your comments and experiences. Love your happy story Tattycatty! I´m going to go to A&E in the morning and tell them the situation and see if they will send me up for a scan, you never know, I could be there hours (with my 2 yr old!) but I think it is worth a try. I am going away for 3 weeks and am too nervous to wait that long.

Ive been on heparin throughout both my (IVF) pregnancies, and was started on them from embryo transfer - there's some evidence to suggest that early use of heparin can help with implantation. Have you had a beta HCG yet? They can also indicate the likelihood of ectopic pregnancy by seeing what the levels and relative rises are.
In your shoes I'd take the heparin. V best of luck x