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Anti Thrombin III and Pregnancy

I was 10 weeks pregnant when I threw multiple pulmonary emboli...I had so many clots in my lungs they couldn't even count. I was started on Lovenox, a really high dose twice a day for therapeutic reasons, and will be on it until I'm 34 weeks ( I'm currently at 33 weeks) at which time I'll switch to regular heparin. My clots were caused by Factor V Lieden, a genetic trait that I was previously unaware of. My baby is healthy and fine so far and even though both the hematologist and my perinatologist said it 'could' cause a lower birth weight my baby has been measuring well within the average range.

Im on lovenox shots right now for an undiagnosed clottting disorder - well, it only shows up (they think) when im pregnant and effects only the baby. From what ive gotten from my hemotologist, lovenox is a low molecular weight blood thinner, similar to heparin. Im not sure exactly how similar lovenox is to what you are taking now, im sure all blood thinners share the same purpose, but i think it would be safe to assume you would be on a higher dose than most, which is at max 80mg a day (i think, i could be a little off) They also may pair it up with baby asprin (or low dose bayer) Find out if you can try it out for a couple of months and see where your levels would be then start trying. Either way, it shouldnt be a problem. also, close to delivery time you would be switched to heparin because heparin is easier to test for in your system and its much easier to reverse if need be. I think the delivery would be the only real issue you would come across, which the periOB would make up a plan for you - they are great like that.

oh and lovenox injections sting a bit, stock up on a couple of reusable ice packs to numb the injection spots.

The biggest difference between Lovenox and Coumadin (other than coumadin being unsafe during pregnancy) is that Lovenox last longer in the system. B/c it is a low molecular weight heparin it lasts longer and is more stable. As I'm sure you're aware with coumadin routine PT/INRs are needed to see if the dosage of coumadin needs to be adjusted where as Lovenox doesn't require any PT/INRs. Lovenox isn't really reversible, the medication they use to reverse it isn't always 100% effective and so as PP and I mentioned before, you'll probably switch to regular weight heparin sometime in your last trimester. Regular heparin is still more stable and longer lasting than coumadin BUT it isn't as long lasting as Lovenox and it IS reversible. The Ob said I would be induced in order to safely control coming off the heparin in time for the epidural and delivery so don't be surprised if that is also the pan for you.

As EOKANE6098 also mentioned you will most likely be started at a prophylactic dose of Lovenox which is typically 40mg injection once a day. The maximum dose is slightly higher than what I am currently on which is 90mg injected 2xs a day but that's a therapeutic dose. Therapeutic doses are continued for 3-6 months after a clot excpet for us preggos, in which case, for the duration of the pregnancy and sometimes for a little while after. ( In my case, at least, b/c my condition was only brought out by the hormones in pregnancy considering I've had heart surgery and been on BC without any issues for years). Oh and definitely get those ice packs b/c Lovenox does sting when injected and I also suggest trying to pinch the injection site to desensitize it a little more, which we do at work all the time.