Factor 5 leiden heparin or asprin in pregnancy?

[Flowerlover010]

Ive been told ive got factor 5 leiden heterozygous and the doctors have given me the option of 150g aspirin or heparin injections at 6 weeks pregnancy and leaving it to me to decide. A lot of people dont even know they have this and go onto have successful pregnancys without either. I dont fancy the injections every day but at the same time obviously want a safe pregnancy without mc! I worry whether the aspirin is enough. Any one else had this decision to make?

Unfortunately blood clotting and pregnancy and postpartum is a real risk, even to mothers without thrombophilia. My MW said it was the leading cause of maternal death postpartum (when I asked her for help getting a refill of Clexane ).

I don’t have factor V but it runs in my family along with a family history of DVTs and PEs, so I’m assessed as being moderate risk. With DVs 1-3 I was on aspirin during pregnancy, Clexane (low molecular weight heparin) for 6 weeks postpartum. Having DC4 meant additional risk so instead I was put on Clexane in pregnancy for third trimester plus 6 weeks postpartum.

One of my relatives didn’t know they had thrombophilia when they were pregnant - it was a long time ago and there was a lot less in awareness and screening. They were back in hospital a couple of days PP with a newborn due to a DVT although thankfully they were fine.

Taking aspirin or Clexane in pregnancy is very common, lots of women have to do it if they’ve conceived through IVF for instance.

Hopefully that’s some reassurance and best wishes with your pregnancy

Sorry just realised I missed the whole bit about heparin vs aspirin

I would hope your consultant would give you more direction on that? My consultants have been very clear on their recommendations in each pregnancy. In my first two pregnancies I was under a top haematologist/leader in the field (by chance, she was based at the hospital I was at for antenatal). She was really clear on her recommendations and wrote them into my notes for future pregnancies! My clotting risk care has been clearly directed by consultants each time, I wasn’t offered a heparin vs aspirin choice as such, just told what they advise and then I consented.

Thank you for your reply. Im guessing Clexane is also injected. Im just really not sure on the injection vs just taking aspirin. I know the injection each day will cause me a lot of extra stress in pregnancy which is also not helpful.

Yes, Clexane is the name of a low molecular weight heparin which you inject daily (sorry, so used to just using its name, but it is one of the most common to give in pregnancy).

If your consultant is really equal either way about it then do whatever works for you. Perhaps they can give you more info from their perspective to help your decision? I have had aspirin and it’s not really one for side effects AFAIK so I didn’t notice it, just took it each day. Clexane is a different ball game due to the injections, but I just focused on the fact that it meant I was being well taken care of! But I was advised very clearly by my consultants every time I went on Clexane so it was just the thing to do.

I have factor v Leiden and had the injections, I was told by my specialist at the London clinic which leads on this that aspirin was not enough.

The injections are hard to do to yourself but you will manage, and it's worth it for a live baby. I lost five before having the injections.

Factor V is (in my understanding) part of the coagulant clotting system, so potential clotting needs to be treated with an anticoagulant like heparin or clexane. Aspirin is an antiplatelet, and works on platelet factors but not coagulant factors. The two can be used together, but can’t be substituted for each other as they do completely different things, even though it might sound like the same thing because they are both used to prevent clotting.

I have APS (so platelet clotting factors) and had miscarriages before my diagnosis. I have clotting family history and asked so many times to be tested or treated as if I was before I was officially diagnosed. My most recent pregnancy was successful and was due to aspirin and heparin together. The injections sounded awful to me at first, but when I got down to it they weren’t so bad, and I didn’t even notice them by the end of pregnancy - preferred to do my own in hospital after delivery, too! Whatever you decide I wish you the best, but my advice would be to take the injections, take whatever is offered to you so you have a successful pregnancy, because the alternative is awful and just not worth the risk. Xx

I have this but only found out after I'd had my three children. When I had a hysterectomy I had to have heparin injections for 6 weeks after, which I administered myself. To be honest, the injections are nothing to worry about. It's a very small needle and you inject into the fat around your middle.

I would go with the injections.

I would take the aspirin too, as it is effective in preventing pre eclampsia, which factor VL increases the risk of developing. X

I was told to do both. The injections are fine, easy to do, you just get used to it. There is some bruising though.

Thank you for your reply do you mind me asking if you are heterozygous or homozygous factor 5?

Thank you all for your replies they are helpful

I have factor 2. I only found out after having 3 miscarriages. For this pregnancy, I began BOTH 150mg of aspirin each day and Clexane ever since the day I found out I was pregnant which was 12 days after my embryo transfer (IVF) so I was technically 4 weeks.

I'm 6 months pregnant now and have been advised to continue injections and aspirin throughout the whole pregnancy. The injections aren't great and do leave some bruising over time but I feel it's worth it. I couldn't go through another loss again.

I’m heterozygous.

I'm heterozygous