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High-Risk Pregnancy
Lovenox Question
Hi ladies, never posted here, but have a question on Lovenox.
I had an early miscarriage recently (1st and only pregnancy) and my Dad just died of a PE a few weeks prior to that. Those two things combined made my doctor run blood tests. LOTS of them. It came back I had Hetero MTHFR, A1298C, one copy. He sent me to a hemotologist who says that what was found in that blood test is insignificant and normal but due to the miscarriage and my Dad's situation he still wants me on Lovenox.
Is that normal? If my tests are normal I can't help but feel I'd be doing it for nothing! What happened to a baby asprin? Most people I've seen on Lovenox have the compound mutation or a PE history themselves.
Obviously I'm going to do it if I have to. I HATE needles and almost pass out when getting blood drawn. This is going to be a huge obstacle to overcome for me.
Just wanted opions and thoughts from others with experience.
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Re: Lovenox Question
First of all, I am so sorry for your loss(es)
Here are my thoughts based on my situation and the research I've done.
The idea of the Lovenox is to prevent you from having a PE, since you are more likely to clot when you are pregnant, and are already predisposed to forming clots (genetically passed down from your father.)
Did you have your homocystine levels tested? The docs usually determine whether or not you need thinners based on whether your homocystine levels are abnormal or within the normal range. If your homocystine levels are normal, maybe you technically do not need the thinners, but I would definitely err on the side of caution and take the thinners if your hemotologist wants you to. I WISH someone had tested me and put me on Lovenox before I developed a DVT, PEs, lost my baby at 13 weeks, and now have permanent damage to my veins.
If you are looking for an alternative to the Lovenox, for MTHFR, a lot of us are taking extra folic acid and extra B-vitamins. You might look around for a high-risk OB that can advise you about vitamins and may even recommend the aspirin as well.
Please keep us posted on your progress!
"You reach deeper until you can find the strength. That's all life is, one big fight after another."
Angel babies: 9/19/07, 10/08/09, 1/05/11
IMO, I think it's good they put you on the lovenox.
I am also Hetero MTHFR, A1298C. I have a history of DVT when I was on BCP's 4 years ago. Because of my history I was put on lovenox.
My sister is also Hetero MTHFR, A1298C but since she has no history of any clots she was not put on anything for her pregnancies and never saw a hematologist. I asked my hematologist if she should have been put on something and he said yes, given my history he would have put her on the lovenox too.
The needles are so thin they barely hurt. What will hurt is the burning of the medication as you inject. You will want to rub the injection site to stop the burning DO NOT RUB IT! You will bruise like crazy! I mean, you're going to have big nasty bruises anyway, but they will be lots worse if you massage. Just lay down for a few minutes after you inject and the burning will gradually away.
I'm on lovenox with this pregnancy and have never had a clot or conclusive thrombophilia test while not pregnant. However, multiple times I've had questionable tests on various indicators and while miscarrying the last time a severe protein S deficiency. All of that has led my doctor to prescribe it to be for this one.
The shots aren't as bad as I was expecting - easier than getting blood drawn because the needle is tiny and it's quicker than filling a tube so you get to withdraw it faster. My husband has given me 3 so far - the first 2 I didn't want to look, but I watched last night as a step towards giving it to myself.
My Chart My Nest Bio
I also had my homocystine levels tested when I had the DVT and they were slightly elevated. After I stopped BCP they dropped back to normal. Definitely an important test to do and hopefully they did it with your blood work.
I have Homo c677t, so it's a different situation. I had 4 mc (3 before dx) and am, obviously, on Lovenox now. Doctors have differing opinions on the proper protocol for addressing MTHFR during pregnancy, you've had 1 loss and family history of clotting so your doctor sounds like he'd prefer to be aggressive in your treatment. I'll admit that the shots aren't the most fun I've ever had but they're not terrible by any means and for me it's worth the peace of mind that comes with knowing I'm doing everything I can to keep this baby alive. Good luck!
ETA: I'm also on Methylguard (extra B vitamins) and Folic Acid.
I also have MTHFR hetero A1298C and two OBs I've seen have been totally unconcerned about it. My RE and my MFM, however, haven't taken things so lightly. My RE put me on BA and Lovenox and my MFM insists on monthly growth ultrasounds for me. In addition, I also tested positive for lupus anticoagulant. I've never had a clot, but I couldn't get pregnant until on Lovenox. My first cycle on it, I got pregnant.
I'm the proactive sort and don't care much if the Lovenox is overkill...I'd rather give myself a little shot everyday knowing that it could be helping me keep my baby alive rather than taking my chances with miscarriage.
I agree with many of the things the ladies are saying. My thought was... how will I feel if I DON'T do the lovenox and have a m/c? I personally would feel terrible and always wonder if I could have prevented it through the lovenox injections. I have already had 1 m/c and don't want to go through it again.
I have mthfr. When I'm not pregnant, all of my levels look fine. Its when I'm pregnant that things get out of whack.
I m/c my first pregnancy and developed a blood clot during my second pregnancy. I had testing done and was immediately put on lovenox and aspirin. And I firmly believe that's what kept me pregnant!
You are at a higher risk for clotting when you're pregnant. And given your history, you are probably at an even higher risk.
The lovenox isn't a big deal. You get used to it. I just becomes part of your routine, like taking your pnv. In the grand scheme of things, its only a few short months that you have to be on it.
Thank you all for your thoughts. I know it's the best thing to do. It's just a little hard for me to swallow. It's nice to know I'm not the only one going through this.
I'm not sure if they did the homocysteine levels, no one has said anything about that to me.
I'll keep you updated!
This is exactly how I feel. If I don't do it and have another loss I'll feel terrible. If I have a successful pregnancy I'll never know if it was the lovenox or not but at least I did what I could.
So sorry for the miscarriage and the loss of your Dad. It seems like the Lovenox is a good idea for you. I have had one miscarriage, then a preemie born at 28 weeks due to pre-eclampsia, then a loss at 23 weeks due to a placental abruption and blood clot. Thankfully my little boy is now doing fine. But, after the abruption, I was tested and found to be hetero for a prothrombin gene mutation (factor II). I have never had any clots, blood pressure issues, or any health issues outside of being pregnant. For this pregnancy I am taking daily Lovenox shots. My hemotologist told me that based on my pregnancy history alone, even with no blood clotting mutations, he would put me on the Lovenox. I am not sure what dose they want to put you on, but I do one 40mg shot per day. I was told by the doctors that this is a prophylactic dose, and I could techincally have surgery safely while still being on such a small dose. Good luck!
Oh, and P.S. - I LOATHE needles and blood draws of any kind. But honestly, the shots are not that terrible. Very thin needles, and you get used to it.
I am so sorry for your losses.
I too only have one copy of the MTHFR A1298C mutation and am on Lovenox. I was tested for everything else but that is the only thing "wrong" with me. I had three losses that were unexplained though I do also seem to have progesterone problems in early pregnancy - I do not have them during ovulation nor as the pregnancy progresses.
For my DD1 who I was pregnant with 2 years ago, I only was on baby aspirin and progesterone during early pregnancy. I then went off both around 14 weeks. She was born without incident at full term.
I then had another (my third) loss when TTC again and went back to the RE. In the 2 years, her treatment of patients with only one copy of the mutation had changed to include Lovenox. I am on 40 mg once a day from about 5 weeks until 36 weeks. I will not be switched to heparin or any other blood thinner at that time and will be allowed to progress to the end as long as everything looks good. I was on baby aspirin during TTC and up until 12 weeks for this pregnancy.
The Lovenox is kind of an annoyance, but nothing more. I ice up the area and make sure to lay down for about 5 minutes following the shot. I now never get any bruises and hardly any marks from the injections. I had DH give them to me in the beginning but am so used to it at this point that I now give them to myself.
I wish you the best of luck and hope you are pregnant with a healthy baby soon.