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Lovenox during pregnancy


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  #1  
November 24th, 2013, 07:05 PM
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Join Date: Nov 2013
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Hi,
This is my first post. I'm not sure if I am putting this in the correct place, but has anyone been on Lovenox during pregnancy and then had to have a C section? I developed a blood clot after my first pregnancy - had to have a c section. Baby would not drop and was two weeks over due. I am in the process of seeing if my doctor would allow me to get pregnant again. I have had a few doctors give me different advice. I am just curious how things work for people who need to be on a blood thinner because of a dvt and then what would happen if you end up needing a c section? Thank you.
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  #2  
November 24th, 2013, 09:48 PM
ashj_1218's Avatar Hiya!
Join Date: Jul 2010
Posts: 11,577
Chances are that you would not be a candidate for a VBAC. They would want to plan your delivery carefully (ie: stop meds, 24 hours later deliver, restart meds). So they would probably opt for a scheduled c-section at 39 weeks. They even like to plan vaginal births, scheduled induction at 39 weeks, with the same criteria. But my understanding is that induction is not recommended for women with previous c-sections. So I think they would just plan another c-section. I take lovenox in my pregnancies, but have yet to have a c-section. My understanding is that the protocol is the same though...planned births for better med management.
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  #3  
November 26th, 2013, 08:31 AM
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Thank you for your response. Do you have any information to share about giving yourself Lovenox shots while pregnant? How do you give yourself shots in the belly when you are pregnant? Have you had a previous DVT? I'm scared because I know it's a risk if I do get pregnant but I also don't want to live my life in fear. We are not even trying at this point just gathering information. I would love one more child but my situation is not just an easy one. There are lots of risks involved.

Were there any concerns with taking Lovenox that could cause the baby issues? Can you breast feed while using it?

Thank you.
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  #4  
December 5th, 2013, 12:04 PM
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Join Date: Dec 2013
Posts: 1
Hi there! Are you normally on Coumadin for the blood clots?

I normally take Coumadin because I have a mechanical aortic valve. I switched to Lovenox when we decided to try to get pregnant. I have been doing the injections twice a day for several months while TTC. They haven't been bad! My doctors are only planning on keeping the Lovenox for the first trimester and then going back on Coumadin for the remainder of the pregnancy. We will switch back to the shots at the very end in order to prepare for the C-section.

I am currently 5 weeks pregnant. I will have another planned C-Section (I wasn't on blood thinners with my first child).

We are very similar in our situations. I don't want to live my life in fear either. It is very risky but I have great doctors and I know miracles happen every day so I am really counting on that to pull me through this!

Best of luck with your decisions. I know they are very difficult.
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  #5  
December 5th, 2013, 01:12 PM
ashj_1218's Avatar Hiya!
Join Date: Jul 2010
Posts: 11,577
Quote:
Originally Posted by Miagirl View Post
Thank you for your response. Do you have any information to share about giving yourself Lovenox shots while pregnant? How do you give yourself shots in the belly when you are pregnant? Have you had a previous DVT? I'm scared because I know it's a risk if I do get pregnant but I also don't want to live my life in fear. We are not even trying at this point just gathering information. I would love one more child but my situation is not just an easy one. There are lots of risks involved.

Were there any concerns with taking Lovenox that could cause the baby issues? Can you breast feed while using it?

Thank you.
I have not struggled too hard with the shots, but I am not one to be squimish about things like that (I have gotten blood drawn and had IVs often in my life, not related at all to the clotting issue). Amazingly enough, giving shots in the pregnant belly sounds worse than it is. You still have a little layer of fat and muscle on top of the bump that you can pull up a bit to make a pocket to put the shot into. It sounds scary, but it's only scary the first few times you do it. Make sure a nurse shows you how to do it properly. And it does burn a little bit when injecting the solution. And you will bruise pretty intensely. Your pregnant bump won't be pretty down where the shots are. But it's pretty small potatoes compared to not have a baby, ya know?

I have not had a DVT. My mom had a serious blood clot after having leg surgery back about 10 years ago. I had my first child in 2009 and he was premature with a degraded clotty placenta (but not premature enough to warrant tons of testing). After my first, we started trying for our second as soon as my post partum period came back. But had a string of losses ranging from 4-9 weeks along. We had testing done and I tested positive for a blood clotting condition that has the potential to cause clots (my mom has since been diagnosed with the same condition). So I started on aspirin daily and then have to also take lovenox to maintain a pregnancy. Which seemed to work, since I have two healthy children (both were term babies) while using lovenox.

From what I know, there are some risks of taking lovenox. The package insert lists a few. I truthfully tried not to read it too carefully, since I knew I had to take the meds no matter what and I was already so nervous after my losses. I know it will automatically make your pregnancy more monitored. I had multiple ultrasounds and the docs start NSTs and BPPs around 34 weeks. Just as a precaution. Once the baby is here, lovenox is not thought to have lasting effects on the child. Although I guess they can't be sure. My children have not had issues at birth or after. If I remember correctly, lovenox does go into the placenta, but doesn't cross into the baby. Therefore any complications wouldn't be with the baby itself, but rather complications of the placenta. If you know what I mean by that. I don't think the baby is affected by the medication. But, again, this is all from memory. I don't have a box sitting around here otherwise I would look for you. You would ask your doc about that specifically.

And I don't have any experience nursing extendedly on lovenox. I only took it for a week after birth then stopped it. But, yes, it was fine for me nursing in that week. No nurse ever mentioned not taking it (I guess because the risk-benefit analysis was in favor of it). I don't think they really know much about taking it while nursing, since it's so hard to have a controlled study and most women who take blood thinners on a regular basis take a different one (Coumadin, Heprin, etc). As far as I know lovenox is not a typical maintenance drug. I only have to take aspirin not pregnant. So I don't know much about the stronger blood thinners and nursing.

Sorry I don't much more. I do understand making that risk analysis. It would be harder knowing I had had a clot before. But mine is mostly preventative. I know that ladies who have had clots in the past often take a higher dose of lovenox and the doctors usually monitor the levels to make sure it's at the best dosage. I think with the proper following by a doctor, your pregnancy could be pretty low-risk. If you aren't getting the information you need from your current doctor, I would try to find someone who has experience with lovenox and blood clots in previous pregnancies. The doc who managed my second two pregnancies was very knowledgable and answered all the questions I had very thoroughly. He is even fine with us wanting another child. I had a complication with my most recent birth (no way to know if it was caused or complicated by the blood thinners, they also could have helped the situation, we just don't know) and asked if I was risking anything by having another and he is fine with it.

I hope you can gather the info you need to make a choice. Sorry I don't have more fact-based info. I'll look for the insert and see if I can get you more info when/if I find one.
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  #6  
December 10th, 2013, 03:48 PM
Orangebrittainy's Avatar Queen of Randomocity
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I take Lovenox twice daily because I have an Artificial Aortic Valve, different doctors will treat this very differently. I couldn't find any doctor comfortable enough to switch me back to coumadin for 2nd/3rd trimester so I have been taking this shots for Most of my pregnancy.

Its really not as bad as it sounds, but I still hate them. My belly has grown but the fat I had still stays so I have plenty of it to pinch up and inject with. Its interesting when baby is kicking, but so far the kicking hasn't interfered with taking shots. I can see my veins pretty well, so I avoid those areas to keep from bruising and most of the time you can't tell I take lovenox. You'll also find certain areas of your stomach are more sensitive than others, I tend to avoid those as well, but the bigger my bump got those areas started to change.

Most of what makes Lovenox hard for me is a mental thing, not the actual shot. I know its a mental thing, so I can deal with it better. I can take the shot pretty much anywhere I go, and have taken it in all sorts of interesting places.

The biggest thing to prepare for with Lovenox is the cost. Most insurances don't like to cover it. Some won't at all, so you need to look to see what your insurance will cover. Mine pays all but $140 for it. So I have to come up with $140 dollars every 25 days (My insurance would only pay for so many boxes but that should not be a problem unless you are taking it twice a day)
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