Pregnant Women on ACT

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Duff Man

Duff Man

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This thread isn't exactly heart related, but it does relate to Anti-Coagulation.

Basically, my wife is pregnant and she has a history of a pulmonary embolism and a DVT in her leg. She went to the OBGYN today and although she's asymptomatic, the clots occured 7 years ago, and the recent ultrasound of the leg's DVT looks stable, they want to put her on some form of light ACT, in particular Lovenox. They said there's a significant increase in hormones that can cause clotting during pregnancy. All I want is a healthy, normal child and wife.

So, from what you know (I'm especially seeking the women's advice), is Lovenox something that can cause birth defects? Is there a better drug out there with less risk of birth defects? Does this sound like a reasonable plan of action for the circumstance? I'm totally clueless about this stuff.

Thanks in advance gang.
 
I'm glad to hear your wife is doing so well and I wish you the very best as you seek to expand your family. Warfarin is the drug that needs to be totally avoided during (most of) pregnancy. When someone is on warfarin (generic for coumadin) then Lovenox is the drug that a woman is put on to avoid the risks of warfarin. And Lovenox is the safest way to go.
 
I think the lastest news on ACT and pregnancy is that Lovenox is used during the first trimester in order to prevent the possibility of birth-defects that warfarin can cause in the first as everything is being formed. We had one or two members here lately who went through an "ACT pregnancy" and they switched to warfarin during the 2nd trimester and back to Lovenox for the 3rd.

Lovenox is used in the 1st tri because warfarin can cause birth defects in the developing baby. Once all the parts are formed (by 2nd tri) warfarin is okay. I think the switch back to Lovenox for the 3rd tri is to have the control of INR and getting it dropped quickly in preparation for delivery.

If your wife doesn't want to give herself shots 2 times a day for all 9 months she may want to ask about warfarin for the 2nd trimester if things are going well. It will be easier to watch her INR then too.

Best wishes for a healthy baby and wife!
 
Duff Man said:
This thread isn't exactly heart related, but it does relate to Anti-Coagulation.

Basically, my wife is pregnant and she has a history of a pulmonary embolism and a DVT in her leg. She went to the OBGYN today and although she's asymptomatic, the clots occured 7 years ago, and the recent ultrasound of the leg's DVT looks stable, they want to put her on some form of light ACT, in particular Lovenox. They said there's a significant increase in hormones that can cause clotting during pregnancy. All I want is a healthy, normal child and wife.

So, from what you know (I'm especially seeking the women's advice), is Lovenox something that can cause birth defects? Is there a better drug out there with less risk of birth defects? Does this sound like a reasonable plan of action for the circumstance? I'm totally clueless about this stuff.

Thanks in advance gang.
Click to expand...

They put me on Lovenox when I was pregnant but it was because I was
in a. flutter. Pregnancy does change the body's hemodynamics,so if she
is prone to clots for an internal reason I would say she definitely needs
to be on the ACT. I know that coumadin is only dangerous to the baby
for the first few months. One doctor wanted to switch me to coumadin
later but I was never sure if I trusted this or not in spite of what I have
read. My cardio was planning to keep me on Lovenox thru the preganancy.
There is a danger of osteoporosis for the mother but this doesn't occur
until after 1 year of taking it. I wish I could give you more definitive info
but I didn't carry to term-thru no fault of ACT. And remember I am probably
atleast 10 years older than your wife:)
Congratulations
If you want, your wife can PM me,Dina
 
Thanks for your advice and well wishes guys. I really appreciate it. I'm a big caveman when it comes to this stuff.

Anyone know if the osteoperosis is reversable? Could the woman just take a calcium supplement to counter-act the effects of lovenox?
 
She will be on pre-natal vitamins, most likely. Vitamins and supplements should be cleared with her OB-GYN for safely sake. You ask a good question and she should ask her doctor.

Best wishes.
 
Duff Man said:
Thanks for your advice and well wishes guys. I really appreciate it. I'm a big caveman when it comes to this stuff.

Anyone know if the osteoperosis is reversable? Could the woman just take a calcium supplement to counter-act the effects of lovenox?
Click to expand...
I was told that in order for me to be in danger of the osteo is if I took
the Lovenox for over a year continuosly,but I would ask your cardio
(or perinatal).Sometimes I get good info from pharmacists - Allodwick
may know also.

And don't worry,most of the best husbands and fathers are of the
"caveman" variety:D
 
If lovenox isn't needed for very long -- at least not for months and months on end (like 1 year) -- don't think it will be a problem.

However, pregnant women have an increased demand for calcium because it's needed to help the developing baby grow. After delivery, it's needed if the mom is nursing.

It's the same for all species, in fact. I've seen it with the litters of kittens I've raised.
I have a litter of 2 Norwegian Forest Cat kittens right now -- born 9/22/08 -- and I'm giving mom supplements. She may have only 2 kittens, but they're big ones, the largest almost 1 pound. That puts a terrific demand on their mother and if she doesn't get enough extra calcium, they can't grow at the proper rate and it can impair the mother's health.
 
OH - MY - GOD. Lovenox is 1,100 dollars for 34 days at walmart's pharmacy, and like 950 dollars at walgreens. I already faxed the completed needymeds.com prescription assistance form to her OBGYN at 08:30 today and I hope they've already faxed it in to the manufacturer for a decision.

If I don't get an answer by tomorrow (friday), we're going to have to fork up some dough, beg for some dough, whatever, and get her on it... I am not taking any chances. The site says the application process takes 24 hours. I'm crossing my fingers...
 
Duff Man said:
OH - MY - GOD. Lovenox is 1,100 dollars for 34 days at walmart's pharmacy, and like 950 dollars at walgreens. I already faxed the completed needymeds.com prescription assistance form to her OBGYN at 08:30 today and I hope they've already faxed it in to the manufacturer for a decision.

If I don't get an answer by tomorrow (friday), we're going to have to fork up some dough, beg for some dough, whatever, and get her on it... I am not taking any chances. The site says the application process takes 24 hours. I'm crossing my fingers...
Click to expand...

Pick up the phone and call Sanofi Aventis. They will help in emergencies.
 
Yes! Got the Lovenox syringes in the mail. BUT, it occurred to me that it might be prudent to monitor her INR while she's on a higher than "theraputic dose" as the doctor called it. Basically he's saying there's a difference between say, 40mg and 100mg. She's on 100mg, so he says she's anti-coagulated ipso facto.

Whuchu think? Should we be monitoring her INR?
 
INR tests only show effects of warfarin/Comadin on the blood.
Lovenox doesn't affect the INR.
If you're on Lovenox and are off warfarin 100% and have been for more than, say, 72 hours, running an INR test is money down the drain. At least, that's the way I interpret it.
 
Duff, I'm glad you are getting your supplies.
And it's true that INR is only a reading used for Coumadin/warfarin meds.
Your wife may need other blood tests to check her clot or platelet factors.
 
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