Pulmonary Embolism and anticoagulant injections

[leticiapm1]

Hello,

I'm 23 weeks pregnant with my 3rd baby and last week I woke up with a strong central thoracic pain (chest) and then I lost consciousness at work. Paramedics came and recommended me to go to the ambulatory center at hospital. I have not have any kind of problems in my previous 2 pregnancies.

I was diagnosed with pulmonary embolism (and the leg scan came negative and they found "significant" blood test results for it).
They recommend that I had the VQ scan done but after reading the leaflet they gave me I panicked (1 in 250K chances for my baby to develop cancer in later life did not convinced me at all to have it).

The consultant was clearly annoyed about my decision of not having the VQ scan done, as he couldn't do a proper diagnosis, and he put me straight away onto anticoagulant injections (which I hate btw). He kind of scared me about not having the scan as they might be complications during labor and so on.

I've had so far 6 injections since diagnosed and these might have cleared the clot (or maybe not), but they said that having the VQ test done now will not exempt me from continuing with the injections, even if the results are negative... so what's they point of having the VQ scan?

Is anyone in a similar position to me? I feel really scared and anxious and the prospects of having a difficult delivery (more bleeding than usual) doesn't give me peace of mind, to be honest...

Thanks to whoever takes the time to read this and replies!

Leti x

I was suspected of having a PE in pregnancy. I did have the VQ scan which was clear so injections were stopped. I had the scan after only a couple days though, not a week.
I would guess by this point, if you have the scan and it's clear they don't know whether there was a clot that's cleared or not. You need to talk to the doctors, but they're limited as to what they can do if you didn't have the scan. They need to err on the side of caution to keep you and baby safe.

I developed bilateral PEs in my last pregnancy. I had the VQ scan which identified them. I was then put on twice daily Clexane injections up to the delivery and then daily thereafter (I'm still on them now, 10 weeks later).

Sorry, pressed post too soon.

The fact that you have the clots means you are at higher risk of developing further clots even if the original clots have gone, so they must be keeping you on the injections as a precaution.

At some point the consultant should do a birth plan with you, and they will likely say that they want to induce you in order to avoid the bleeding risks. If so, they will set out a withdrawal schedule so that you are clear of the anticoagulants before induction begins. You'll be very closely monitored during the induction and then put back on anticoagulants after the birth for a few weeks.

I collpased from massive PE due to a clot in my leg in early pregnancy. I had no idea I had a clot, I thought the pain was a torn muscle. I was put onto heperin injections, one a day for the duration of my pregnancy which also continued 2 months after the birth. I had to inject them into my thigh and was covered in bruising from them. My clot happened after an injury - hence me just thinking it was a torn muscle.

I struggled throughout the pregnancy because of the loss of lung capacity due to the damage from the PE, which also knocked my heart out of wack (I had to be resucitated) and I have an irregular heartbeat they think because of that. I also blamed the heperin for developing depression during my pregnancy but I have no proof that is what caused it. (3 previous pgs no issues at all with depression).

I was due to be taken off the heperin 3 days before birth - baby was breech and head too large, so they wanted to do a cs using epidural. However he came a few days early and due to the meds I had to go for a normal delivery as epidural too risky with the heperin (theres a high chance of spinal bleeding/paralysis with heperin) and a general was not an option except in absolute emergency because of my heart defect. however all turned out good and he was absolutely fine. I did have a huge team, a total of 10 doctors, nurses, midwifes in the delivery room though on standby for any issue.

In your position I would opt for the VQ scan. Otherwise you will have to stay on those meds for the whole pregnancy and could develop further complications. I always wonder if my baby was breech due to the meds or the stress of these injections and my depression. I had to have actual xrays of my belly and baby in order to determine which type of birth was more risky - the natural or risking a general anesthetic. Plus way more scans than normal. The VQ scan is so much less risk than any of that and means they can either put together a plan for you or put your mind at ease if given the all clear.

Hi OP, I'm 27 weeks pregnant with #3 and was diagnosed with a massive DVT and PE at 13 weeks. I did have the scan (never got a leaflet on it mind you). I'm on 2 injections a day (morning and night). I haven't had a problem with bruising too bad - alternating legs and moving about right after.

I had no previous issues or risk factors for it.

I see a consultant once a month and have blood checks to see if my levels are good. One doctor mentioned being induced, but others have said when I feel contractions to just not take my next injection. No epidural for 24hrs after last injection and I'll be monitored more closely but other then that all seems more or less straight forward so far.

And I'm even almost getting used to these daily shots ... Almost!

I was also diagnosed with a massive DVT and PE at 4 weeks. I didn't have a VQ but an MRI on my leg confirmed the clot so I've been on Clexane injections twice a day since and have to stay on them for the near future (I'm not 26 weeks). They are horrible but you do get used to them. I'm also seeing a Antenatal Consultant every 4 weeks, Consultant Haematologist every 8 weeks and have to see an Anesthatist (sp?) soon to discuss bleeding during labour. Also been told an epidural is out of the question if I've injected within 24 hours so they are talking about an induction, but I don't want one. Also been told to go to hospital as soon as I start feeling any labour pains as I can't labour at home, oh and I can't have a water birth either, so all in all pretty crappy. This thread is good though, thought I was the only one!

I'm currently in a similar situation. Have not been diagnosed with anything as yet but have terrible varicose veins in my right leg. These are becoming more painful. I have to see a vascular surgeon this week to see what the next step is. I have already been prescribed a 3 day dose of blood thinning tablets to alleviate initial pain and been told I will more than likely have a Doppler scan?? I don't know much about it but have been told I may have to have herapin injections :(

Reading all your posts has me slightly worried. I def want to go with a water birth and don't want to be induced. Was with DC1 and didn't like it.

Hope all you ladies take care :)

Hi, I was diagnosed at 18 weeks ( now 39+5). I had the scans done In order to find the problem. I do two injections a day and I suspect if you don't have the scan and they are concerned you will need to do the injections to the end of your pregnancy plus 6 weeks after like me. It means you are unlikely to be able to have an epidural ( not allowed within 24 hours of injection) and will need general if having a cesarean. I too was concern d about the cancer risk but didn't really get a choice. Without it, I m not sure how they know you have PE. 6 injections won't clear the clot if you have PE as it takes at least a few months for your body to reabsorb it or them.

Good luck with whatever you decide. The injections aren't bad once you get used to them and there are alternatives to epidural as I'm about to find out :-)

Good luck Olive, you'll have to let us know how it all goes!