Factor V Leiden & Pregnancy After Stillbirth: Understanding Risks & Options

Question
One year ago, I suffered from an unexplained stillbirth. My daughter died at term during the last five minutes of the pushing stage of labor due to unknown causes.  I am currently pregnant again and due in 12 days.  I recently learned that i have heterozygous factor V leiden.  I wonder if this could have caused my daughter's death and am worried that it could happen again.  I believe that it is too late to take any kind of treatment and am wondering what i can do to increase my odds of a safe delivery.  I spoke with a hemotologist who didn't think that i should be concerned but i am looking for a second opinion.  What are my options at this late point?  

Answer
We are usually not concerned with heterozygosity to Factove V Leien as to it pertains to throbophilia or pregnancy loss. This is usually seen more often with Factor V Leiden homozygous. However, it is hard to predict what your risks are. Two studies show that pregnancy outcomes among women with recurrent pregnancy losses are no different with or without fact V Leiden. The data is still coming in and there is much controversy in the field as to wehter Factor V Leiden is something to worry about or not.  I cannot say what the cause of your prior fetal demise was. Certainly, at this stage of pregnancy, there is nothing to do. I would not start Heparin or any other anticoagulant at this stage in pregnancy. Just be vigilant during labor, use a fetal monitor, and interfene at any signs of distress. Most probably, all will go well. Use Oxygen during labor as well. Good Luck.