17wks prescribed heparin and aspirin... opinions??

[Myalterego1]

Ok so some background
Have 4 dc ages 14. 13 11 yrs and last baby 11months next week. currently 17wks pregnant on baby no 5... had my hospital check up yesterday and doctor has prescribed all the following to be taken daily
75mg aspirin tablet
7750ui heparin injection
100mg vit D
Galfer iron supplement...
Been told as have following risk factors all above needed
high bmi - mine 40
Age over 35 - 40 this month
3 or more babies - baby no 5

Also have low iron 4.3 and haemoglobin 11.2 from recent blood test

So my questions are why the need for injections and aspirin? I know they saying to avoid blood clots but dont see how all this necessary as all the "risk factors which decided this course of action were present in last pregnancy less then a year ago . Also been told to stop injections 12 hours before Labour but 3 of my 4 previous pregnancies went from 1st signs to delivery rapidly no time for any pain relief my 1st was Induced and I found drugs slowed every thing Down .
Also with low iron and haemoglobin I can't see how blood thinners is a good idea.....

I would love to hear if anyone else been put on this course of treatment....or what people's opinions on it are ... I have to collect injections from chemists in morning and I'm not liking the idea also if anyone has done this how best to inject never shown or told just told read leaflet enclosed 😡
Apologies for long post

Hey!
I have factor V a genetic blood clotting issue so was on heparin and asprin for my last pregnancy and this one.

For me it is necessary to take this to prevent baby getting a clot in the placenta and to stop me getting a clot (so i take 6 weeks post natally). My pgs that i didnt take this ended in MC so for me.it's vital (dad's aunt died of a post natal blood clot too :(

I would recommend moving the injections to the morning as you're most likely to go into labour overnight. This time im stopping at 36 weeks but yes the risk is (a) they wont give you an epidural if the injection was recent or (b) an emergency c section will be more risky for you. If you have a gas and air birth it shouldnt really be an issue.

Disclaimer - im.not a doctor so dont follow any of my advice over your obs.

Injecting - you need to squeeze the fat between your finger and thumb and inject into that, as you get bigger this is more tricky. Im slim so also an issue not having the.needle come out the other side but it os possible if you angle it right.

Position - needle needs to in at least 2.5 inches from.belly button below the belly button line. You can go as.far as your "sides"

I tried doing my legs which is also am option but too bloody painful.

You will bruise, try to keep subsequent injections away from bruised skin

Alternate left and right

If it really hurts when you first go in then you may be touxhing a. Vein which will bruise more, come out and shift the needle slightly. This really helps to avoid bruising.

Ice and arnica are ok if you can be bothered.

The bruises tale ages to go PP i think due to the reason that makes lina negra (sp)

Wipe all drips off the needle before injecting as.this increases bruising

A sort of diagonal angle. Works best

Feeling tingly or weird under the skin straight after for a min or 2 is normal

The further down you go the more it hurts! The fattier the fat the less painful

It took me a couple.of days to get the needle in properly.as my brain wouldn't let me hurt myself but i did.do it.

Hth!

Oh also if theres a bubble. Inside the needle this is fine you don't need to pre squirt

MulderitsmeX... Thank you so much for the detailed reply learnt more off you then the doctor they Just told get them and take daily never say how r where to inject... for you it was clear why you were put on this but I'm still baffled as to why I am this time and not last pregnancy as risk factors no different and I'm under the same consultant hoping other have some experience of this... if this was done on last pregnancy i would understand as was 11 years between that one and previous pregnancy but it's only been 10 months since I gave birth last and had zero complications in that pregnancy.... guess they just like changing the goalposts 🙄

Myalterego1anytime :)
Yes i agree it does seem like it potentially could be an over cautious thing in your case, i dont think this is something every hospital wpuld do either. I know they can change their guidelines very quickly (eg im on a different asprin dose this time as opposed to ds who was born last year), maybe they set a benchmark at 40 so since you were 39 last year you didn't qualify? Obvs agreed tho you won't be that different to last year but sounds like a tick box thing.

If you're worried about c sections maybe you could ask if you can stop at 36 or 38 weeks?

I noticed you mentioned about iron levels too, last time i was im my 2nd trimester i had super low iron levels and blood pressure (latter normal for me) i didn't think of it being connected but it was shit as i kept fainting so hope it's not a thing with blood thinners!

Also be aware you'll possibly feel super cold always due to the thinners, at least if we get another hot summer it won't affect us i suppose!

Good luck doing the injections and it will defo get easier doing them! Xx

@MulderitsmeX

Sorry hope you don’t mind me asking but do you have heterozygous or homozygous factor v Leiden?

I have the heterozygous type so the less risky one and was prescribed blood thinners and aspirin at 7 weeks pregnant by a hosp midwife , my hospital don’t seem to be very clued up and over the weeks weren’t sure wether to keep me on medication, they then recommended just aspirin and said with blood thinners it’s upto me if I continue or not which i didnt find very helpful. I’m so worried about getting a clot in the placenta I’m thinking il just carry on 🤷🏻‍♀️ It’s very confusing ! x

Pulmonary embolism used to be the leading cause of maternal deaths in England. Then risk assessment tools were brought in following extensive research.
Risk assessment is standardised using a chart that totals up risk factors and scores.
It is possible that a couple of things have tipped you over into the higher risk category since a year ago - possibly your age and number of pregnancies, given that you say nothing else has changed.
Your midwife could show you the system used and explain this further.
I do understand your concern about quick labour and you should definitely discuss this with your midwife.

The detailed information can be found by googling the RCOG green top guidelines on thromboprophylaxis.

Thanks everyone for replies I know I had the same risk assessment sheet n my file last time but no one went through it and if use weight on last pregnancy i would have got risk factor of 3 and should have started this treatment at 28 wks by that recommendation but it was never done. so I guess it's just this time got a doc who follows these guidelines. this time I scored 4 so should have started n 1st trimester but again midwife didn't do at booking in appointnent at 12wks and only done now at 17wks ... I'm torn between doing week of iron and aspirin and seeing if doc will re check bloods for iron level and quiz him more on starting injections after that ... what would ye do