Clexane in pregnancy

[pinkie93]

Hi everyone,

I'm 21 weeks pregnant and just feeling absolutely awful today. Everything is going great with the pregnancy, all the tests have had good results and the 20 weeks scan measurements were all well within the normal range.

I am 25, with BMI in the 30's at the moment (health BP and low cholesterol), I also have an extremely mild case of lymphoedema in my right leg which developed while I was suffering from Anorexia 10 years ago. No varicose veins, doppler test showed good blood flow in the limb. But suddenly today I got a call from the Obstetric doctor saying that she had spoken to haematologist and they want me to inject Clexane everyday for the rest of my pregnancy. Apparently the risk factors for DVT are my weight and the lymphoedema. I have no personal or family history of DVT, the haematologist won't see me because it isn't serious enough and nothing has shown up in my blood tests to say I'm at increased risk. But I feel so much pressure from the obstetrician, she just wanted me to go pick up the prescription without any proper explanation of why I needed it or an appointment to discuss it. I don't even know how to inject.

I want to say I won't take it until I've seen a haematologist, but I feel so judged for "going against medical advice". What would you do? Are they being reasonable?

[pinkie93]

I also read that women who've actually had a DVT in pregnancy would only have to stay on blood thinners for 3 months, while they're asking me to be on them for 5 and half months in total.

[baby2016]

I have been on clexane since before my ivf transfer to prevent me miscarrying due to a blood clotting issue, at 14wks I had to change over to tizaparin which is a similar drug as my NHS are swopped to tizaparin due to their being a UK shortage of clexane. If you google there are no real negative effects to pregnancies and it had been proven to prevent miscarriages or stillbirths in many pregnancies. I hope this helps, it is prescribed in many ivf pregnancies now a days x

[pinkie93 in reply to baby2016]

Thanks for the reply, I'm just really concerned that they don't seem to be listening to me at all. I've had serious unexplained bleeds in the past that have led to hospitalisation, surely that should be taken into account? I don't have any blood clotting issue, if anything I have the opposite problem. It took me 15 mins to stop a nose bleed last week.

[baby2016 in reply to pinkie93]

Have you asked for a second opinion? I hope you get it sorted either way soon as I know how anxious it can be. I was so scared to change from clexane to tinziparin as well as having to reduce my dose. Hoping it gets sorted quickly for you xx

[baby2016]

I'll also be on it until the end of my pregnancy and also have to take 1x 75mg of aspirin a day x

[JessRose in reply to baby2016]

Are you administering yourself or taking a trip to the hospital everyday? And are they planning for you to go full term?

[baby2016 in reply to JessRose]

I inject myself. Up untl 14wks i was on 3 injections and day, so its nice to be down to one now 😊, and yes the plan is to go full term I think although this has now been discussed fully, i presume if planned c section i'll stop the day before x

[Dreamingofbaby]

I’m on in at the moment too til 12weeks poss but maybe longer. U inject in belly under belly button. Suggest u ice the area first as injection is v stingy. Not fun unfort but worth it if helps best wishes x

[JessRose]

I have literally just been in hospital today with suspected DVT - started me on the medication, sending me back for some sort of scan in the next day or two but likely I’ll be injected everyday until the end of my pregnancy! Surely they can’t keep that up until 40 weeks! I have no history, BMI is normal, everything is normal... I just had rib pain along my back, shortness of breath and a dry cough!

[pinkie93 in reply to JessRose]

I hope all is well! It really does feel like they're way over cautious now, it's all box ticking and covering their own backs. I forgot to mention I've literally had to be hospitalised for a huge unexplained bleed in the past, still they think blood thinners are a good idea!

[JessRose in reply to pinkie93]

Humn! I think you need to check that out before you agree to anything, it might be something really simple to put your mind at ease that they come back with! Hopefully!

[pinkie93 in reply to JessRose]

Maybe I'm being stupid, but I genuinely am really scared. After that bleed I had to stay in hospital for a few days. I was white and blue, sweating profusely, if I sat up the room span and if I stood up I collapsed, it was terrifying.

[baby2016 in reply to JessRose]

This is def the right course of meds for you then. Blood naturally thickens in pregnancy and can then have serious effects on the baby, so by keeping the blood thin helps prevent DVT and protect your baby x

[sarahmark]

I'm not sure I understand why they want you to either but put it this way you don't want a DVT or pulmonary embolism during your pregnancy. I had a pulmonary embolism and it nearly killed me, almost all pulmonary embolisms start as a DVT. All I would say is if they want you to inject if they feel your at risk of clotting then do it . They must have a good reason why . As for injections you inject in the tummy pinch some skin together around the belly button level . Then at a straight angle push the needle in until it stops. Now push the plunger down slowly until it stops then gently pull out. Do not rub it after or your cause more bruises. Also this medication is safe it does not cross the placenta if it's painful to inject wiggle your toes to put your mind on something else. Dispose in needle bin from your doctor or council don't push lid or your lock it and have to get another lock it when full as it will be safety locked. I had two massive clots one in each lung at 6 weeks pregnant so did clexane injections twice a day for rest of pregnancy and up to 12 weeks after as everyone in the world is at risk of clotting after pregnancy and everyone in hospital or after a operation .

[JessRose in reply to sarahmark]

Did you administer yourself and Did you go full term?

[sarahmark in reply to JessRose]

Yes I did them myself and she was 3 days early I had a natural birth and every thing was fine I had no pain relief and was only on oxygen due to my clots in lungs . You will be fine try not to worry and enjoy your pregnancy don't let it ruin it. 😁

[JessRose in reply to sarahmark]

That’s brilliant, thank you, I have to admit I have been worrying!

[sarahmark in reply to JessRose]

Don't worry and good luck x

[Hidden]

You’re well within your rights to ask for an appointment to help you better understand the reason for this decision, particularly in light of your concerns regarding your tendency to struggle with bleeding and that this is a blood thinner. Your concern does not seem unreasonable to me it just shows you want to know more.

Medical professionals are busy, stuff gets missed (with the best will in the world) and we have to advocate for ourselves sometimes.

Hold firm, trust your gut instincts, give a clear explanation as to why you want an appointment (either with the doctor or specialist) and make it known that you’re not going against medical advice you simply need to feel fully informed. If necessary, put it in writing your concerns and what you’re asking for (that usually gets people’s attention because then it’s documented and has to be logged).

I would feel the same as you under the circumstances.

Good luck.

[Hidden in reply to Hidden]

p.s I used clexane post major surgery (not during pregnancy), it’s not the nicest thing to have to do every day but it’s not terrible either; IF that’s what you end up having to take

[Lizzielizzielizzie]

I took fragmin from 28 weeks until six weeks after birth which is a similar drug to clexane because I had risk factors and basically even questioning the consultant closely, if the NICE guidelines show that you hit the relevant risk factors then they’ll just tell you you need to take it. I was told it can be life threatening not to so I did it even though I really didn’t enjoy the daily injections.

Make sure you get full blood counts done regularly- I ended up needing iron tablets which I’m sure was because of the fragmin and aspirin I was taking, because it wasn’t my haemoglobin levels that went wrong it was something else.

[Bex31]

Hey hun , I had a DVT with my last pregnancy. I had to inject clexane from 10weeks pregnant up untill 12weeks after having baby . I had to have c-section & i refuse to carey on injecting after due to the pain , i was then given Warfarin (tablets) instead . I had no family history of DVT . I probably wouldn't of injected either but with what i know now & having had a DVT my advice will be to take it .xx

[pinkie93 in reply to Bex31]

I'm sorry you had to go through that, but it still only happens to 5-10 in every 1000 pregnant women and there are other precautions you can take against it. Using personal experience and applying that to everyone else isn't really logical. I've had a very big unexplained gastrointestinal bleed which left me in hypovolemic shock and close to death. But that's not a reason to say that no one else should ever take blood thinners.