PREGNANCY-BIRTH Messages for March, 1999: Re: Heparin during pregnancy, do I really need it???

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Re: Heparin during pregnancy, do I really need it???

From: William D. McIntosh, MD (anonymous@obgyn.net)
Sun, 28 Mar 1999 11:48:30 -0600 (CST)

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At Sun, 28 Mar 1999, Jody wrote: >
>I am 29 years old and currently 27 weeks pregnant with my second chld. I
>wsa recently diagnosed with having activated protein C deficiency and am
>also heterozygous for the Factor V Leiden gene. The only reason I got
>tested was that my second cousing was diagnosed with this after
>developing a blood clot (10 years after having her triplets) while on
>bed rest for a back injury.
>This spawned testing from within her immedidate family and has made it's
>way down to my side. I have had no previous history of clotting and had
>no probelms with my first pregnancy. If I had not been tested I would
>have contiued on with this pregnancy without knowing that I am now prone
>to clotting and I probably would be fine. Now that the doctors know I
>have this deficienct they want to start me on heparin via injections
>twice a day. I feel this is extreme, considering my past history.
>I do not know what to do, I am torn, should I continue and just be aware
>of my condition, ...or do I really need to start these injections. There
>doesn't seem to be any hard and fast rule, and there is only one
>hematologsit in my area and I would like some other oponions other that
>his.
>
>HELP....Jody Safnuk, Canada

If you were my sister, or my wife, I would strongly urge you to take the heparin. The first sign that you had anything wrong could be sudden death from a massive blood clot in your lungs. This may only have a 1-2% incidence, but is it worth running that risk if there is a safe and effective treatment? And that's just the risk of death, not lesser morbidities. You are prone to making unwanted blood clots, both from heredity and from pregnancy. I have a 16 year old in the hospital right now, 10 days postpartum, who almost died from a pulmonary embolism, that does not have as many risk factors as you do.

If you were told that you had 1 chance in 4 of having an auto accident during one specific trip to the market, I bet you would take extra care to wear your seat belt. Why is this any different?

-- William D. McIntosh, MD Clarksville, TN

This is for educational purposes only. It is not intended to replace consultation and examination by your physician or other health care provider.

Next message: Thomas: "Re: Heparin during pregnancy, do I really need it???"
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