A
Anthony
Hi everyone. Willow is now in her 25th week of pregnancy. Now if you haven't been following our previous post read them to get up to speed.
As you already know Willow is on her second pregnancy with a St. Jude Mitral Valve. Okay, she started on Lovenox then onto Coumadin with the plan to switch to Heprin prior to delivery. Willow also has a bicorniate uterus. This means the baby can only grow in half of a uterus. When Willow had our first son he was born at 1 pound 12 ounces. He was 28 weeks. He actually stopped growing at 26 weeks. She had pre-eclampsia and the beginnings of Healt Syndrome (Organs in body shut down.) The baby was in fetal distress and so they did a C-Section and delivered him. Then they found a clott on Willow's valve and a week after a C-Section she had heart surgery to replace the valve. This was her third heart surgery. After having preclampsia the risks again are very high. So after much research Willow and I found that the reason for the clott was poor anticoagulation of lovenox. As many of you know Lovenox was band by the FDA for a short period. Willow was one of the reasons why. We think Lovenox is still the correct choice through the first trimester as long as the hospital and doctors can measure the FACTOR X's and know the proper dosage. The proper dosage is not based on weight it's based on factor X's and in a minute you will get my point on this.
Most hospitals can't. We did research and found Dr. Elkayam of USC. They have the ability to do same day results and he writes the majority of papers for the American Heart Association on valves in pregancy. To transfer to heprin or lovenox from coumadin must be done in a hospital. Willow was on lovenox for the firs 17 weeks of her pregnancy and then transfered back onto coumadin. We had and echo done at UCLA by the top cardiologist, who is also the head of the Heart Congenital Program and he gave us the thumbs up. She did not have a clott. (yeah) Because we were off lovenox and new that UCLA could monitor the coumadin and heprin for delivery we chose them for the second half of the pregnancy. We got the very best OB in the country. Dr. Tabsh. He was advisor to senior President Bush and is the head of the UCLA OB program. He then got the very best hematologist at UCLA to monitor the change over to heprin. We then requested to have Dr. Elkayam and his team as additional consultants. We probably have 20 to 30 doctors consulting on this case.
Okay UCLA is ranked #1 hospital in the west. We have the very best doctors and they admitted to us they have never handled a mitral valve pregnancy. They also can not do factor X's for same day results.
Willow started having contractions last week and was hospitalized. Because the baby could hemorage if delivered on coumadin they decided to put her on heprin. Now they thought that they could just give her shots. I told them that they needed to put her on an pump. Doctor Elkayam fealt the same way. UCLA agreed and did it. They figured a change over would be easy. Well guess what her levels have been all over the place. She is suppose to be at about 60-70 on these levels. She should never go past 90. Well last night after the change she was at 180. AAARRRGG. But then Dr. Tabsh wanted to try a different approach to the dosage and today she is finally between 60-70. Now many of them thought the change over would be easy and I was being too cautious with the pump. They now realize that the pump was the only way to go. Okay, they have given her medications to stop the contractions and the cervix hasn't opened. She still has contractions but they are much more controlled. Her blood pressure is fine.
Great news! The baby looks great. They did several ultra sounds and tests. Our baby girl shows no defects. Is coumadin right after the first tremester? Yes, yes, yes. Willow did great on coumadin. Lovenox and Heprin are much harder to monitor and control. Willow is probably going to be at UCLA the rest of her pregnancy. But the baby and her so far are doing well.
Take Care,
Anthony
As you already know Willow is on her second pregnancy with a St. Jude Mitral Valve. Okay, she started on Lovenox then onto Coumadin with the plan to switch to Heprin prior to delivery. Willow also has a bicorniate uterus. This means the baby can only grow in half of a uterus. When Willow had our first son he was born at 1 pound 12 ounces. He was 28 weeks. He actually stopped growing at 26 weeks. She had pre-eclampsia and the beginnings of Healt Syndrome (Organs in body shut down.) The baby was in fetal distress and so they did a C-Section and delivered him. Then they found a clott on Willow's valve and a week after a C-Section she had heart surgery to replace the valve. This was her third heart surgery. After having preclampsia the risks again are very high. So after much research Willow and I found that the reason for the clott was poor anticoagulation of lovenox. As many of you know Lovenox was band by the FDA for a short period. Willow was one of the reasons why. We think Lovenox is still the correct choice through the first trimester as long as the hospital and doctors can measure the FACTOR X's and know the proper dosage. The proper dosage is not based on weight it's based on factor X's and in a minute you will get my point on this.
Most hospitals can't. We did research and found Dr. Elkayam of USC. They have the ability to do same day results and he writes the majority of papers for the American Heart Association on valves in pregancy. To transfer to heprin or lovenox from coumadin must be done in a hospital. Willow was on lovenox for the firs 17 weeks of her pregnancy and then transfered back onto coumadin. We had and echo done at UCLA by the top cardiologist, who is also the head of the Heart Congenital Program and he gave us the thumbs up. She did not have a clott. (yeah) Because we were off lovenox and new that UCLA could monitor the coumadin and heprin for delivery we chose them for the second half of the pregnancy. We got the very best OB in the country. Dr. Tabsh. He was advisor to senior President Bush and is the head of the UCLA OB program. He then got the very best hematologist at UCLA to monitor the change over to heprin. We then requested to have Dr. Elkayam and his team as additional consultants. We probably have 20 to 30 doctors consulting on this case.
Okay UCLA is ranked #1 hospital in the west. We have the very best doctors and they admitted to us they have never handled a mitral valve pregnancy. They also can not do factor X's for same day results.
Willow started having contractions last week and was hospitalized. Because the baby could hemorage if delivered on coumadin they decided to put her on heprin. Now they thought that they could just give her shots. I told them that they needed to put her on an pump. Doctor Elkayam fealt the same way. UCLA agreed and did it. They figured a change over would be easy. Well guess what her levels have been all over the place. She is suppose to be at about 60-70 on these levels. She should never go past 90. Well last night after the change she was at 180. AAARRRGG. But then Dr. Tabsh wanted to try a different approach to the dosage and today she is finally between 60-70. Now many of them thought the change over would be easy and I was being too cautious with the pump. They now realize that the pump was the only way to go. Okay, they have given her medications to stop the contractions and the cervix hasn't opened. She still has contractions but they are much more controlled. Her blood pressure is fine.
Great news! The baby looks great. They did several ultra sounds and tests. Our baby girl shows no defects. Is coumadin right after the first tremester? Yes, yes, yes. Willow did great on coumadin. Lovenox and Heprin are much harder to monitor and control. Willow is probably going to be at UCLA the rest of her pregnancy. But the baby and her so far are doing well.
Take Care,
Anthony
