Lovenox Worries

heatherlynn321 · December 2016

I got my blood work back and met with my RE again. I tested low for vitamin D, so she has me taking vitamin D supplements in addition to my prenatal vitamins. I also tested a low positive for anticardiolipin antibodies, which can cause tiny little blood clots in the placenta. So she has me taking baby aspirin until I get pregnant and then she will switch me to daily Lovenox injections which is a different type of blood thinner, for the first trimester. She's also going to test my progesterone levels on Monday to see if I need to go on progesterone too. So hopefully things will go better next time.
I'm really nervous about taking Lovenox, I looked it up and it has a list of side effects and mile long. I'm also worried about only taking it the first trimester as I've read most women who take it take for the whole pregnancy plus a few months. Does anyone have any experience with Lovenox or only took it for a few months of your pregnancy? I feel like if the antibodies can make me miscarry in the first trimester they could make it happen anytime.

RiverSong15 · December 2016

@szwill86 What were your antibody results? Have you been tested twice? To be diagnosed with Antiphospholipid antibody syndrome, you need to have strong positive ACA results on two blood draws over 12 weeks apart. Illness and stress can both cause these antibodies to spike temporarily. My RE said unless my ACA results were over 40 on both tests 3 months apart, she wouldn't diagnose APS. She OKd baby aspirin in any case. But Lovenox is a serious blood thinner. Many women take it and have successful pregnancies, but I'd recommend doing some research on your own on the diagnosis and treatment. Many insurance plans won't cover the prescription costs unless you meet the strict criteria for APS (my insurance is one of these companies - I did some research when my ACA results came back indeterminate). Also, I'd recommend talking to other Grads who are on it (@a2003tiger and @sparrowmomma24?) I think you might need to take it for your whole pregnancy - my RE said blood clots from APS become a bigger problem in second tri and beyond. Your REs recommendations are throwing up some flags for me.

KyCade3013 · December 2016

I tested a low positive too, 28. They told me I'd likely be on baby aspirin and Heprin. Why don't they want you on that or maybe you can suggest that one? It's an injectible too but with less side affects. I'm scared as hell honestly, but I think it's the type of thing that you get used to doing and do it because you have to.

NYTino24 · January 2017

@KyCade3013 @heatherwilson321 @RiverSong15 @a2003tiger Did you ladies have other bloodwork that was abnormal? My ACA was 12, so just above the acceptable 11 when I was 6 weeks. Therefore the hematologist somewhat ruled out APLS, but he couldn't be sure of what is going on due to several other abnormal results. I had a previous VWD diagnosis that was also ruled out. I am supposed to see a perinatologist but I have tried to get the nurse to call me back for four days and haven't gotten an answer. Here were my other results. I was told I may need baby aspirin or Lovenox after they repeat testing.

RiverSong15 · January 2017

@NYTino24. I'm on mobile, so I cant see the test results and what else they tested. If you can repost them, I'd be happy to look at the other results. I had a lot of bloodwork done after my second loss to look for causes of RPL. I'm not an expert by any means, but I read up on a lot of it.

Was this the first time they measured your ACA levels? My results came back "indeterminate" too (at a 16), above the cutoff of 11. To completely rule out APS, they retested me 12 weeks later (and it dropped to 10 or 11). So they ruled out APS for me. FWIW, my RE said for APS to be truly diagnosed, ACA needs to be really high after 2 blood draws (like, in the 40s), and that it usually causes problems in the second tri, not the first. But redrawing blood at least 12 weeks after the first draw is standard practice of care if anything comes back abnormal. Lots of things can raise your ACA temporarily, including recent illness or stress, which is why the make you wait 12 weeks. When I expressed concern that my ACA levels were still close to the indeterminate range, not my RE and my OB said I could take a baby aspirin daily once I got another positive. For diagnosed APS or clotting disorders, Lovenox is the standard of care, and improves pregnancy outcomes greatly. The data is inconclusive on aspirin alone, but my RE's, OB's, and my opinion is that it can't hurt, so might as well try it.

GL getting in to see the specialist!

ETA: I had nothing else related to blood clotting disorders that was abnormal.

NYTino24 · January 2017

Here you go @RiverSong15! So much seemed to go wrong. I had a lot of headaches and bloody noses in the first few weeks. My normal 90/60 BP was up to 116/75 the first time I got it checked and was up to like 123/85 the day after my MC. I started losing pregnancy symptoms right after I got sick (two days of sinus drainage through eye looked like pink eye, went away to be followed by two days of bad sinus headaches, followed by three days of sore throat / negative strep test, and finally coughing. I also had bad pain in my left hand and knee. None of the symptoms were at the same time. I started bleeding once I was coughing and taking Mucinex Fast Max (pharmacist said it was okay.... I would NEVER take it again because of the phenylephrine). We DTD and I noticed my cervix seemed high / I had EWCM mucous the next day (probably lost my mucous plug). My boobs stopped being sore and I wasn't as bloated / consipated. I told DH to pray for two days before I started bleeding at 7w3d. Doc wasn't worried until I called back and was given an ultrasound the next day, Thursday. We saw a heartbeat, but baby was measuring 6w. Doc wasn't worried, but I had the hematologist send over BM from two weeks before and they both wanted me to see a perinatologist. I started having contractions that night and never heard from HR. When I called again they said they would possibly see me Monday or Tuesday once they could look at BW and get a history. I miscarried that Sunday and never got to make that appointment. Since then I have emailed three times to make sure they got all of my BW since the doc's personal nurse (the only one I can go through) indicated she got different stuff than I had the one time I did get through to her. I also called three times (three different offices) and was told she can access her email and phone messages from every place. I'm getting very pissed since I know she had been at work. I might just show up to the one office on Monday with the BW to be copied since I have off and have to go to the other OB for my HCG test. It's so frustrating to not know what to do next.

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