Postpartum Blood Clot & Systemic Lupus: A Patient's Experience

Question
Dear Dr.
   I am 32 years of age, 5 months postpartum, I was diagnosed with a blood clot during the first month of pregnancy, and I was diagnosed with Systemic Lupus 12 years ago.
   I had a c-section and 3 days later developed a huge blood clot under the incision site at which time the dr.s had to operate again to take it out.  After that surgery the incision site opened when the staples were taken out and I had to heal by secondary healing.
   For the past three weeks I have been having a menses that is heavier then normal and big clots have been coming out as well.  This never happened to me before so I went to the emergency room at which time they told me to see an OB/GYN and that my hemaglobim levels were in normal range.
Today I had an ultrasound done and the tech told me that I have a very large blood clot in my uterus (which was confirmed by my dr.).
My question is, is this dangerous and what should I expect in terms of what the dr.'s can do for me?  I have been experiencing dizziness and discomfort in my uterus, but all the doctors have told me to do is stop taking my warfarin and check in with them next week.  Is this right and should I not be worried.
In case it helps I am currently taking warfarin, prednisone, plaquenil, methotrexate, folic acid.

Thank you for your time,
Tepa

Answer
Dear Tepa

To me, it does not seem you have a major problem. If this is a very large blood clot as the tech and your gyn thought, it would have affected your blood hemoglobin level to a critical level which did not happen. At your age, some hormonal imbalances are common, known as dysfunctional uterine bleeding-DUB, and are easily treated with hormonal therapy. This form of DUB may show on ultrasound as thickened endometrium and is responsible for heavy menses. I do not think that systemic lupus or the medication u take have a relation with your complaint.

I advise a repeat scan in 1 week and proceed according to results. There may be no clot at all. If a clot was present, it may disappear or gets smaller that requires no treatment or may turn out that it is endometrial thickening.