QuestionHI I AM 24 YEARS OLD AND I AM 6 MONTHS PREGNANT AND I AM TAKING A BLOOD THINNER CALLED LOVENOX 40 MG A DAY. I MISCARRIED LAST YEAR AT 4 MONTHS. IT WAS FROM WERE MY BLOOD GOT TO THICK AND CUT THE BABY'S BLOOD OFF AND I LOST IT. SO WHEN I GOT PREGNANT THIS TIME THEY PUT ME ON THE SHOT LOVENOX. IT IS WORKING GREAT FOR ME. THIS BABY IS DOING GOOD. THE PROBLEM IS I GOT BLOODCLOTS IN BOTH LUNGS RIGHT AFTER I HAD MY 1ST CHILD. SHE WAS 3 MONTHS OLD WHEN I GOT THEM. I GOT THEM FROM BIRTH CONTROL. SO I CANT TAKE NOTHING THAT IS CONSIDERED A BIRTH CONTROL. WHEN I GOT THEM BLOOD CLOTS. THE DOCTOR SAID I ALMOST DIED. I HAVE HAD SEVERE PANIC ATTACKS SINCE THEN. IT HAS BEEN ALMOST 6 YEARS AGO SINCE I GOT THE BLOOD CLOTS AND I HAVEN'T GOTTEN ANY SINCE THEN. BUT I STILL HAVE THE PANIC ATTACKS. I AM ON MEDICINE FOR THIS TO. THE DOCTORS KEPT ME ON IT. THEY SAID IT WAS SAFE TO TAKE DURING MY PREGNANCY. THEY TOLD ME SINCE I WAS PREGNANT THAT I WAS AT HIGHER RISK OF GETTING BLOOD CLOTS AGAIN AND I WILL HALF TO TAKE LOVENOX EVERYDAY TILL THE BABY IS BORN AND 12 WEEKS AFTER THE BABY IS BORN. MY QUESTION FOR YOU IS THAT IF I GO IN LABOR ON MY OWN I CAN BLEED TO DEATH AND IT CAN KILL ME AND MY BABY. SO I WORRY EVERYDAY HOW WILL THE DOCTOR KNOW WHEN I CAN HAVE MY BABY WITHOUT PUTTING ME AND MY BABY IN HARM WHILE BEING ON THE SHOT. I HAVE ASKED HIM ABOUT IT AND HE SAYS EVERYTHING WILL BE OKAY AND HE WILL KEEP A EYE ON THE BABY. I GO TO THE DOCTOR EVERY 2 WEEKS TO BE SEEN WERE I AM AT A HIGH RISK PREGNANCY. MY QUESTION IS HE SAID HE CAN TAKE THE BABY EARLY. HOW EARLY CAN SOMEONE HAVE A BABY BEING ON LOVENOX. I KNOW I HALF TO STOP THE SHOT TWO WEEKS BEFORE I HAVE THE BABY AND WAS WONDERING IF YOU HAVE ANY INFORMATION THAT MIGHT HELP ME ON THIS. I WANT MY BABY TO BE HEALTHY AND I WANT A SAFE DELIVERY. HOW EARLY CAN THE BABY BE BORN AND BE ALRIGHT. IF YOU HAVE ANY INFORMATION ABOUT THIS. PLEASE LET ME KNOW. SO I CAN STAY CALM AND QUITE HAVING SO MANY PANIC ATTACKS OVER THIS. I CANT HELP BUT TO WORRY. BUT IF I HAD SOME INFORMATION IT WOULD HELP ME SO MUCH. THANKS SO MUCH FOR YOUR TIME AND PATIENCE. I HOPE TO HEAR FROM YOU SOON.
AnswerDear Ann,
Anticoagulation therapy with enoxaparin (Lovenox) during pregnancy appears to be safe, according to an opinion from a committee of the American College of Obstetricians and Gynecologists (ACOG). According to Committee Opinion 276 which appeared in the October 2002 issue of Obstetrics and Gynecology, the drug does not cross the placenta. The committee also said enoxaparin should be used with caution or discontinued 18 to 24 hours before administration of epidural analgesia for pain relief during labor.
In one French study of pregnant women with clotting disorders who had a history of a previous pregnancy loss, the results of enoxaparin use were impressive. Of the women on the drug, 86% had a normal live birth. In addition, no significant side effects were seen in these mothers or their newborns. In the group taking an alternative medication, only 29% had a successful birth.
So, please feel better about using Lovenox to treat your clotting condition during your pregnancy. Your doctor is monitoring you very closely if you are seeing him every two weeks throughout the entire pregnancy. Once you get closer to your due date, your doctor may choose to give you a steroidal medication to mature your baby's lungs in order to deliver you early. Otherwise, he may plan to deliver you right at 37 weeks if he feels comfortable with the dating of your pregnancy. Any pregnancy at 37 weeks or more is considered "full term". The fact that you are on the Lovenox won't affect how early he can deliver you as much as the baby's lung maturity.
Again, once delivery time gets closer, your doctor can do tests to determine lung maturity and treat the baby as needed if he feels pre-term delivery is necessary.
I hope this has helped you and answered your question. I wish you well.
Brenda
