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Is anyone on Lovenox/heparin with a breech/transverse baby?

may2806may2806 member
in High-Risk Pregnancy
Hi ladies, I posted a similar q on the natural birth board because I was hoping to have med-free delivery, but I thought I'd get your opinions on my situation as well. I'm 38 weeks on Sunday and on Heparin (1 ml/2x day) for 2 copies of MTHFR and PAI-1. I was previously on 30 mg of Lovenox. All of this is just prophylactic - never actually had a clot. Here's the thing - my baby is still transverse. OB wants to schedule a c-section for 39 weeks. MFM said he is ok with waiting until 40 weeks. There is a chance that baby could turn during labor, giving me the possibility of a vaginal birth; but if he doesn't turn, I am looking at an emergency c-section, and if the Heparin is not out of my system and they can't reverse it I will have to be put under general anesthesia. OB thinks it's better to have it all planned, but a c-section is not without risks either and I would really prefer to avoid surgery. Part of me just wants to stop the Heparin (the doctors don't all seem convinced that I even needed it in the first place) but I don't know if that's smart. Of course I want to do what's best for me and the baby but I honestly don't know what that is. Has anyone been in a similar situation?
Dx: High FSH, stage IV endo, homozygous C677T MTHFR and PAI-1
Early loss 10/08
Lap 1/09
IVF #1 "natural IVF" - 1 egg retrieved, missed m/c
Tried several mini-stim cycles with no response
Switched clinics - dx'd as carrier for Fragile X
IVF #2 MDL protocol Jan/Feb converted to IUI, BFN
IVF #2 take 2: Antagonist, one embie, BFN
IVF #3: Antagonist, no fertilization
One last ditch effort at OE IVF (antagonist with Clomid) cancelled
DE cycle #1 Jan/Feb 2011, BFP, ectopic
DE cycle #2 June/July 2011 - BFP
10/28/11 Baby girl lost at 17 weeks due to pre-term labor. We love and miss you.
DE cycle #3 June/July 2012 - BFP, twins, both heartbeats stopped, D&C
2 frosties but don't know what's next
FET Dec 2012: BFP! Praying this one sticks for the long haul!
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Re: Is anyone on Lovenox/heparin with a breech/transverse baby?

  • luvbostonluvboston member
    I am having a scheduled C section and am changing over to heparin at 34 weeks. However if I go early, the anesthesia team here said that as long as I am on heparin we can wait 12 hours or if its an emergency they have meds to reverse the heparin. I would ask to have an anesthesia consult
    6 m/c
    Anovulatory cycles, increased Synthroid Diagnosed Sep 2010
    Natural cycle Dec 2010 BFP M/C 6 1/2 Weeks, D&E Jan 2011
    1 Clomid/Ovidrel BFN May 2011
    Natural cycle Aug 2011 BFP M/C 4 Weeks
    1 IUI Sept 2011 BFP M/c 7 weeks
    Provera Dec 2011 BFP M/C 3 Weeks
    DQ ALPHA HLA MATCH, High NK Cells Diagnosed Dec 2011
    IVF March 2012 BFP m/c 4weeks 5 days (IL, Prednisone)
    IVF#2w/DS July 2012 MEGA FAILURE BFN (IL, Dexamethasone)
    Diagnosed No real HLA Match, DQ Beta Triad, High TNF, Low NK Cells
    Oct 2012 Natural Cycle m/c 4wks (Lovenox, Prednisone) 
    Went to Beer Center- high tnf, low lad, implantation failure
    Nov/Dec 2012 LIT Treatment
    Dec 12 Humira
    Jan 2013 BFP
    Humira,LIT,Prednisone, Lovenox, IVIG, Baby Aspirin
    Miracle Born August 2013 Premature

    Yours doesn't have to be a sad story


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  • DahliaFlowerDahliaFlower member
    luvboston said:
    I am having a scheduled C section and am changing over to heparin at 34 weeks. However if I go early, the anesthesia team here said that as long as I am on heparin we can wait 12 hours or if its an emergency they have meds to reverse the heparin. I would ask to have an anesthesia consult
    This.  I am both also on Lovenox currently, changing to heparin at 36 weeks.  Basically, the only issue with labor epidural or C-section would be if you had just given the heparin.  Heparin has a short duration of action and if it has been 12 hours, nothing needs to be given, you can just have epidural or spinal.  If it's been less than 12 hours, reversal agents would be available.  Agree w/ PP re. talking to an anesthesiologist at your hospital.  

    However, if my baby is breech at 36 weeks or so, I would personally plan a C-section date to better coordinate with holding heparin.  It can always be cancelled if your baby gets in position later.  
    TTC #1 12/2009
    BFP #1 1/2010, M/C 6 weeks
    BFP #2 6/2010, DD lost to     congenital heart disease, we are heartbroken.

    TTC #2 4/2011, diagnosed MTHFR, FVL
    Four natural cycles BFN; Clomid IUI BFN; Follistim IUI BFN;
    1/2012 IVF #1 BFN
    4/2012 FET BFP #3
    5/2012 7w1d u/s: anembryonic demise; M/C @ 8w.
    6/2012 found Stage II/III endo on laparoscopy, removed w/ laser.
    8/2012 IVF #2 epic fail: no viable embryos.

    Vacation, break, second opinions, on to new RE.
    1/2013 Surprise chemical pregnancy BFP #4 (break cycle), IVF #3 postponed.
    2/2013 TI w/ hormonal support, prednisone, aspirin, Lovenox, acupuncture gave us a miracle BFP #5!
    Heartbeat on U/S at 6w1d!     Baby,please stay!!
    Our miracle baby boy arrived 10/2013!  We are so in love!!

    10/2014 Surprise BFP #6
    Our second daughter arrived in May 2015!  We are so grateful!  

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  • katenpaulkatenpaul member
    DahliaFlower and luvboston are right, you should ask and anesthesiologist because they are going to be the ones calling the shots when it comes down to being able to perform an epidural or spinal or if they would have to use general anesthetics. A true emergency c-section is needed if the life/well-being of the mother or baby are in danger... in most cases c-sections that are unplanned fall into two categories, unplanned but needed (ex: failure to progress in dilation) or urgent (ex: baby's heart rate is elevated because mom has a fever/infection and not ready to push). There are fewer cases where it is a true emergency (baby's shoulders get stuck at delivery, prolapsed cord etc.). Where I work the doctors do not allow you to labor if the baby is not head down because it risks the health of both mom and baby, especially if you are already considered a high risk pregnancy. I do not advise you to stop taking the heparin without discussing things in detail with both your OB and MFM doctors... think about how much effort you have put into conceiving this child, is it really worth the risk? I can tell you that the use of general anesthesia is the last resort for all parties involved in your delivery and that your anesthesiologist would only want to use it for a true emergency.

    I hope this helps you!
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