2nd visit with MFM after tests?

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2nd visit with MFM after tests?

Postby ellemoon » Fri Dec 14, 2012 09:41 am

My husband and I are going to start trying for #2 in March. I've already met with 2 MFMs and gathered information, formed a plan, etc. BUT since I met with the last one, I was diagnosed with homozygous C677T MTHFR (apparently the worst one). I know there are varying opinions on this but given my history of early severe pre-e, partial placental abruption, IUGR, superficial DVT postpartum and chronic high blood pressure...I've decided I definitely want to do Lovenox injections. This article definitely sealed my decision. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3407628/

I know my OB will not be experienced in this and will want me to talk to the MFM. Since I didn't know I had this when I met with the MFM before, Lovenox was not discussed. My question is...should I schedule another appt with him to discuss a plan for Lovenox BEFORE I get pregnant again? or should I wait until I am pregnant? If I wait until I am pregnant, Then I risk running into problems with the MFM maybe not giving me Lovenox and then I will have to find one that will give it to me. I've researched the risks vs. benefits and I know that I want to do it, without a doubt. What would you do?
Leslie (26) DH (28)
Chronic hypertensive since age 17
DD- born April 24, 2011 due to severe pre-e at 29w1d weighing 2lbs, 11oz
Diagnosed with homozygous MTHFR C677T
Pregnant with #2! Due 9/2/13 but will deliver at 36-37 weeks due to classical csection.
(Labetolol, HCTZ, Aspirin 81mg, Calcium, Mag, Zinc, D, Fish Oil, Fiber gummies, Folic Acid)
ellemoon
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Re: 2nd visit with MFM after tests?

Postby sam10 » Fri Dec 14, 2012 11:31 am

I would see the MFM to clarify. For me it was important to have all questions answered and all doubts/worries dealt with in the best possible way. From your post it sounds as though you would want to have this clarified.
I have also the homozygous mutation, however my homocysteine levels are normal. I was not taking lovenox during my last pregnancy.
~Julija (40)
MC 3/2009 and 3/2011
Henry (1/1/2010-1/7/2010) - forever loved and missed; severe PE with Hellp; partial placental abruption, classical c-section at 25.6 weeks
Matilda (Nov. 2012, born at 35.4 weeks) - severe PE


Our pain has been put into words, placed into empty cradles, to remember that all our babies lived, that they mattered and always will. - Field of Cradles http://www.fieldofcradles.org/
sam10
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Re: 2nd visit with MFM after tests?

Postby ellemoon » Fri Dec 14, 2012 01:20 pm

Thank you for your response! I'm so happy to hear you made it almost full term! That's great!

I know that the use of Lovenox for this is controversial and it may not even make a difference. But I feel like if I don't do it, then I will regret it. I've researched this A LOT and I feel like the potential benefits outweigh the risks to me. I will definitely schedule another appointment with them. What should I say when I call? I want to discuss results? I've only seen this person once and it was a consult.
Leslie (26) DH (28)
Chronic hypertensive since age 17
DD- born April 24, 2011 due to severe pre-e at 29w1d weighing 2lbs, 11oz
Diagnosed with homozygous MTHFR C677T
Pregnant with #2! Due 9/2/13 but will deliver at 36-37 weeks due to classical csection.
(Labetolol, HCTZ, Aspirin 81mg, Calcium, Mag, Zinc, D, Fish Oil, Fiber gummies, Folic Acid)
ellemoon
Registered User
 
Posts: 47
Joined: Thu May 17, 2012 02:14 pm

Re: 2nd visit with MFM after tests?

Postby sam10 » Fri Dec 14, 2012 04:56 pm

I would ask for another consult, especially since your medical background information has changed. I think it depends how the mutation manifests (e.g. I don't have abnormal homocysteine levels) which might be a deciding factor or individual pregnancy care (lovenox or not). I do remember I came across an article that excluded MTHFR as a clotting disorder per se. I tried to find it, but am still looking.
~Julija (40)
MC 3/2009 and 3/2011
Henry (1/1/2010-1/7/2010) - forever loved and missed; severe PE with Hellp; partial placental abruption, classical c-section at 25.6 weeks
Matilda (Nov. 2012, born at 35.4 weeks) - severe PE


Our pain has been put into words, placed into empty cradles, to remember that all our babies lived, that they mattered and always will. - Field of Cradles http://www.fieldofcradles.org/
sam10
Forum Moderator
 
Posts: 1436
Joined: Sat Feb 20, 2010 12:04 am
Location: Boston, MA


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