Lovenox, LDA, and C-sections

Are you pregnant again after having preeclampsia once already in a previous pregnancy? Post your thoughts/concerns here - there are others who share your feelings. This is also the home of our Bedrest Buddies Support group.
cheda28
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Re : Lovenox, LDA, and C-sections

Postby cheda28 » Thu Apr 23, 2009 03:31 pm

It is possible to be awake for the c-section as long as they wait out the time to get the heprin out of your system for the most part. Mine took about 8 hours to get out of my system, but I had to take over 10,000ml of heparin 3 times a day. Since they put the ban on giving patients over 5,000ml in one injection (due to the Quaid twins and others) I had 6 shots a day. Talk about a fun time! LOL I was really worried about the epid. but it worked out fine and I had a healthy baby boy at 33 weeks and am pregnant with my second. I would have been really sad if I had to be put under because I didn't have time to get the heparin out of my system fast enough. I wish you the best of luck!


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hannahsmom
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Re : Lovenox, LDA, and C-sections

Postby hannahsmom » Wed Apr 22, 2009 02:40 pm

Wow - ouch!!!! Yes, I know they will get the baby out somehow, some way, so I need to stop worrying. Thank you for your info :)

jenndola
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Re : Lovenox, LDA, and C-sections

Postby jenndola » Wed Apr 22, 2009 02:50 am

Sadly, no--I was completely conscious and undermedicated for my natural vaginal delivery. Suffice it to say, I'm a big fan of epidurals. As a matter of fact, that was the only time I cried during the whole experience. "Oh, my water broke and I'm having a baby at 29 weeks? No problem! Wait...what do you mean I can't have an epidural? Waaaaaaaaah!"

But yes, there are options. They'll figure out a way to get that baby out of you. ;)

kiwi_susie
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Re : Lovenox, LDA, and C-sections

Postby kiwi_susie » Tue Apr 21, 2009 06:09 am

Hi ladies,
I asked my ob about this recently and she said to keep taking it... until I'm admitted (all going well for a nicely scheduled c-section) BUT if I start to notice the evil PE symptoms reappearing then please, kindly, don't take my shot that morning... as in... we'd want to be able to operate if we had to. Guess it's better to know than not be in the know huh? :)

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hannahsmom
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Re : Lovenox, LDA, and C-sections

Postby hannahsmom » Mon Apr 20, 2009 12:51 am

Thank you, thank you, thank you for your positive stories. I can sleep better now. So Jenn - you were knocked out for the delivery?
I asked to be knocked out before Hannah's delivery because I was so terrified, I was shaking, and the more scared I got, the higher my BP went. But I'm glad I was awake. I'm glad to know there are options in case an emergency should arise.

Thanks again, ladies!

hols537
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Re : Lovenox, LDA, and C-sections

Postby hols537 » Mon Apr 20, 2009 08:56 am

I took Lovenox until around 35 weeks when I switched to Heparin. I had given myself a shot only a couple of hours before I went into the hospital in labor. Since it was still early in the labor, they gave me something to stop/slow the labor while they waited until 6 hours after my last shot to draw blood for a coag test. The anesthesiologist would not proceed until the results came back satisfactory (which they did). Jonathan was born about 8 hours after my last heparin shot. Without a history of PTL, they would have switched me to Heparin closer to my planned c/s, but because of my history, the peri switched me earlier. Had I made it to my scheduled date, I would have stopped the heparin the day before (if I remember correctly).

I was worried about it too, but it turned out not to be a big deal. I was also told that it wasn't likely I would require general anesthesia.

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Re : Lovenox, LDA, and C-sections

Postby jenndola » Mon Apr 20, 2009 05:04 am

Yup, yup and yup to what the ladies before me have said. I'm actually a victim of Lovenox--I went into preterm labor after I'd already given myself a shot, and the anesthesiologist refused to give me an epidural, darn her. Different hospitals/anesthesiologists have different policies. If you need an emergency section, like others have said, they'll just knock you out. Epidurals and Lovenox don't play well together--there's a risk for epidural hematoma, which can cause permanant paralysis.

It's definitely something to discuss with your doctor when the time comes, and you might even want to check with the anesthesiologists on staff at the hospital where you plan to deliver.

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jamie w
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Re : Lovenox, LDA, and C-sections

Postby jamie w » Mon Apr 20, 2009 00:00 am

Where I work we only hold the Lovenox for 12 hours prior to a procedure. There is not anything to reverse the Lovenox but in an emergency situation we go ahead and do the procedure anyway. It is a case of looking if risk outweighs benefits. For heparin, they can reverse it with either protamine sulfate or vitamin K. The half life of heparin is shorter- we dose it 3 times a day where we only dose Lovenox 2 times a day. I work in an ICU, not with mother/baby situations but the drug does not change. Hope this helps.

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heather j
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Re : Lovenox, LDA, and C-sections

Postby heather j » Sun Apr 19, 2009 10:49 pm

The issues with anticoagulants are with regard to the epi/spinal, too, because of the risks of spinal puncture *if* you are anticoagulated at the time. They'll do general, otherwise, IIRC. I stopped lovenox (because is has a longer half life) and began heparin at 34 weeks. We stopped it 48 hours prior to delivery. I *think* there are medications available to reverse the effect.

You mentioned concern about developing a clot after surgery ... my nurse was in my room bright and early twelve hours after my surgery holding a syringe with my name written all over it ;). I continued the injections until 5 weeks pp.

Maybe Jenn (jenndola) will pop in; I feel like I make a mess at trying to explain some of this most of the time ;).

suleaf
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Re : Lovenox, LDA, and C-sections

Postby suleaf » Sun Apr 19, 2009 06:11 pm

Well I was only on baby aspirin and they made me stop it supposedly a few weeks before delivery- well.... I had my C section a week later. It was ok but I know Lovenox and Heparin are bigger deals with all that. A friend of mine was on heparin and had an emergency C... and they had some other doctor in there to monitor hte C section? To protect her from the blood clotting issues should they arise. It wasn't a problem.

Good luck though- I found the thought of a C section the scariest thing imaginable....


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