Lovenox in pregnancy
5 Replies
happymommy - September 1

Dear Dr. Jacobs,

First, I want to thank you for taking out your precious time to answer so many questions for all of us! I am new to this board, and find it absolutely amazing that you take such time to help us out!
My question: I am currently in early pregnancy (5 weeks) through IVF. This was an FET, and looks great so far. My RE started me on Lovenox just before transfer of this (my 2nd FET) attempt, 40 mg daily, due to an slightly elevated test result. He said he is using it as a prophylactic. I was told by the nurse that I could expect to be on it for the first 3 months of my pregnancy, and then stop. However, the more I research this drug, the more information I find on everyone being on it for the duration of their pregnancy. I am wondering if there are different protocols for this drug. Any that would warrent one being on it for a shorter time? Also, my only blood test to monitor the Lovenox in my system was done 2 weeks after starting it. I have since read on the internet that it needs to be monitored every few weeks. Is that right? Are there any exceptions to that? Thanks again for your time!

 

B. Jacobs, M. D. - September 2

The reasons to use Lovnox, or any Heparin product can also cause problems late in pregnancy. If I prescribe Lovenox for 1 of my patients, I recommend to her OB that she remain on the drug until labor.
Good luck.

 

happymommy - September 8

[quote author=B. Jacobs, M. D. link=board=5;threadid=4649;start=0#40481 date=1188752464]
The reasons to use Lovnox, or any Heparin product can also cause problems late in pregnancy. If I prescribe Lovenox for 1 of my patients, I recommend to her OB that she remain on the drug until labor.
Good luck.
Dear Dr. Jacobs, I have since learned since posting this question that the exact reason I am on Lovenox as a prophylactic is because I was low on my Protein S. Would this effect your opinion on continueing on Lovenox through the entire pregnancy? I am very confused on what to ask our doctor in relevance if I would need it to sustain the pregnancy. Please help. Thank you. [/quote]

 

B. Jacobs, M. D. - September 9

My philosophy of patient care is that patients need to understand their medical issues and treatments. Truly, some are better equiped to understand more detail than others, but all deserve some explanation. Don't be afraid to ask your physician for information about yourself.
Good luck.

 

happymommy - September 9

Yes, Dr Jacobs, I agree with you totally. But, the problem I am having at this point is wondering WHAT to ask. As you can see from my posting, I have done some research on the subject. However, I am confused on what exactly I should ask to determine whether I would want to stay on the Lovenox for the full term of the pregnancy. Any guidance you could provide would be very appreciated. Thank you, DM

 

B. Jacobs, M. D. - September 10

From my reading, there does not seem to be any evodence that proein S is associated with pre-eclampsia, as are some of the other thrombpphilic problems. That is to say that some of the other things which can increase the risk of miscarriage may also increase the risk of "toxemia of pregnancy". I have found no evidence that a protein S abnormalit is guilty of that particular offence. For that reason, I do not know how long your physician wishes to maintain your Lovenox treatment.
Good luck.

 

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