advice on baby aspirin for superficial clots in late pregnancy..?

[seriouslynonames]

Evening,

Hoping someone can help.

I have always had varicose veins but during this pregnancy (my second) I have had some new veins appear on my right calf. They started like spider/thread veins but are now hideous, dark, lumpy and really painful - sore, prickly, and there are little knotty bits in places that are very painful to touch. My old veins don't bother me and aren't painful.

I have seen the GP a couple of times and been told nothing can be done until after birth, and they prescribed some support stockings. He said these were worse than he'd usually see.

As the veins are worsening pretty much daily I mentioned it to the registrar I saw at AN clinic on Friday. He was sympathetic as has suffered himself and said the knotty bits were small clots in superficial veins - but not DVT so not worried.

He said I could take low dose / baby aspirin daily and with the support stockings I already have that might ease the clots or stop them worsening.
I'm 36+3 so would be taking the aspirin for at least a month, and then probably for a week after delivery.

That sounded sensible at the time and I didn't ask any questions. But when I had a quick look online about aspirin in late pregnancy it really doesn't sound ideal - potential effect on baby's veins and on me (in terms of labour).

Anyone got experience of taking low dose aspirin in last few weeks of pregnancy? Or know of any good research / factual advice? Perhaps the low dose stuff is ok, and I'm just being super-cautious!

Basically am trying to weigh up the risks of taking the aspirin against the risks of the clots worsening if I don't take it (they are close to the back of my knee which is one area where superficial veins join deep veins....). I don't think the registrar was saying that I MUST take the aspirin, more that he was giving me the option as it might help.

Sorry for long post and thanks for any advice!

Hmm, I'm not sure about this. If you are on aspirin during your pregnancy, they normally advise you to stop towards the end, as it can increase the risk for bleeding during labour. That's what I have been told for my pregnancies (I'm pg and taking it since BFP).

I would be hesitant to start it now, to be honest. Do you think you can stick with the support stockings? If you are really worried, can you get referred to a haematologist or venereologist? Someone who is a bit more knowledgeable... Mind you, the opinions on aspirin are very divided!

I was prescribed low dose aspirin when pregnant with DS1. The consultant obstetrician told me to stop taking it towards the end of the pregnancy - can't remember if she said 36 or 37 weeks - because it increases the risk of bleeding too much in labour.

Incidentally, when I went to get my low dose aspirin from the pharmacy, the pharmacist insisted on ringing the consultant to check that she knew I was pregnant when she prescribed it.

But I think I'd want to be talking it through with a doctor before starting to take it, to try and make sure that your concerns are addressed.

thanks both for your quick replies.

Perhaps I need to speak to my GP to get a better idea of relative risks - the bleeding in labour risk was one of the things I was wondering about.

grateful for any further advice / experiences in the meantime.

just one more of the many joys of pregnancy hey?!

thanks

I took aspirin in late pregnancy a few years ago. Had a very very long labour. Was later told that I should have stopped taking aspirin in late pregnancy as it can Ben associated with longer labours... Never researched this so no idea if accurate but might be something to consider.

Was the registrar from the haematology dept, or just an obst-gynae reg? If
you go back to your GP, I think I'd push for a haematology appt, ASAP.

I have a blood clotting condition, Factor V Leiden thrombophilia, one of the several available - and had to have heparin (Clexane) injections throughout both pregnancies to avoid making clots. In the UK, this was managed by the haematology consultant. With the Clexane, I had to stop taking the injections once in active labour (induced both times so relatively easy after all) but its effects only last 24h. I have a suspicion that the effect aspirin has on platelets is more cumulative and therefore longer lasting, but this is why it would be better to have a referral to someone who understands haematology better than either a GP or a OBGYN registrar, neither of whom are likely to be 100% knowledgable about it, IME (the reg who discharged me from the UK hospital with DS1 actually put me on 3x the dose of warfarin I should have been taking - this, luckily, didn't cause me a problem but it probably caused her one after I told the haem consultant...)

Have you spoken to your midwife? I had superficial vein thrombosis immediately after dd2 was born, I was scanned to check for dvt, was referred to haematology and had regular appointments for 3 months, as well as anticoagulant injections for a month. I think they should be taking this more seriously.

thanks Covered, Thumb and Ted. The registrar was OBGYN, not haematology.

I'm going to see if I can get in to see the GP tomorrow and see whether he thinks I need to see someone more specialist as you advise. He's pretty good (if I get to see my usual one, which isn't guaranteed...) and I think he would say if he wasn't sure about something, rather than just brush me off or give advice he wasn't sure about.

For now I'm not taking the aspirin and I'm keeping a close eye on the painful area....

thanks all!

I'm really glad I saw this thread but it has also got me really worried. I've been taking prescribed aspirin 100g everyday since before conception. I informed the midwife of this at my booking in appointment and she never told me to stop. I'm now 36weeks. When I saw this thread I totally panicked. I phoned the midwife and she told me I should have stopped weeks ago and we can't turn back time . I'm now really worried.

Does anyone know what effect this could have for the baby or me?

I'm not up to date with this, but anti-inflammatories such as aspirin can, I think, affect the baby's circulation at a high enough dose.

Worth asking about anyway?

Sorry to panic you Siesta. This was prescribed by obstetric registrar and the midwife I saw afterwards saw the prescription and made no comment - so one would think it's ok to take. Yet so many others have been told to stop taking it at the end of pregnancy. Perhaps it depends what reason you are taking it and relative risks of each particular situation, or perhaps it's to do with length of time you take it for.
But i just don't know enough to feel like I'm making an informed decision about my own situation. I have a call out to my GP this morning and will post again after I speak to him. But I don't know if he'll be able to give any definitive answer. You could try calling the day assessment unit at your hospital to share your concerns and see if they can help explain any issues in the context of your own condition / circumstances.
Hope all ok x

Siesta don't panic! I took 75mg of aspirin throughout late pregnancy and right through labour, birth and beyond. It was only months later that a doc told me I should have stopped! You need to do what a doc says, not a midwife. 100mg is a relatively small dose so really don't fret but do get some advice (from a specialist, not a midwife) asap

Siesta - you should be fine. 100mg is what I was put on to aid conception, and to help reduce the risk of MC (I had 3), it's a normal dose to use in pg, and it has been used successfully throughout pregnancy to reduce the risk of MC/stillbirth in women with anti-phospholipid antibody syndrome (another happy clotting problem! ); if there was a huge risk of side effects then they wouldn't advocate its use.

I'm sure the reason for stopping early is to allow platelets to recover their normal level of function, and so you're meant to stop a bit before giving birth becomes a likelihood. I think 36w would be about that time, tbh, now would be an ok time to stop but you really need to see the person who put you on the aspirin to ask them if you should stop, as it really depends why you've been taking it as to whether you should stop early or not.

Again, best bet is the haemtology consultant for proper advice. It's a specialist field, general docs and obgyns don't know enough about it, and MWs don't either.

Thanks for the reassurance everyone. I've calmed down a bit now! I'm abroad so sometimes don't feel I'm getting all the information that I should be.

I spoke to GP earlier and am seeing him in the morning. He was surprised I'd been prescribed aspirin given what he understands to be the standard treatment for superficial clots, and the potential downsides of aspirin, but he caveated that with not being an expert on pregnancy etc. So will see what he says when I go in tomorrow.
It seems to be appropriate for some conditions and less so for others - so balance of risk will be different for all.

thanks again to all you wise people!

I take aspirin at 75mg a day to prevent miscarriage in pregnancy as prescribed by an IVF consultant. My obstetrician wants me to take 150mg from 12 weeks as I had IUGR ( baby struggled to grow) in my last pregnancy. In my first successful pregnancy I took 75mg all the way through from 4 weeks plus injected clexane due to Factor V Leiden.
I do not have your condition however.