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Treatment for Factor V Leiden

3 posts on this thread and the last post was on January 25th, 2009 9:28 PM
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kohlby - Jan 25th, 2008 10:35 PM
 [Original Post]

Hi! I'm new here and have just spent a long time reading as much as I could on the Lovenox thread. I see my RE in 1.5 weeks to discuss a plan for when I become pg again. I'd like to know what some women in a similar situation were told to do so I know what to ask.

My history is four first trimester miscarriages and two healthy pregnancies. The pattern was mc, mc, sucess, mc, sucess, mc. I requested testing after the last miscarriage and it came back that I'm heterogenous for FVL. Both of my grandmothers have had blood clots. There are stillbirths in my family. My kids were born healthy at 41 and 42 weeks and were 11lb 4oz and 10lb 8oz. (I'm all of 5'1" and passed the 3 hour GTT). My OB recommended just to take a low dose aspirin daily unless I wanted a referral to an RE - which I took and had lots more testing that still only showed FVL as the problem.

I'm confused as to what my risks are since I haven't actually had any blood clots. I've had a lot of miscarriages, but I had two healthy kids too. All the pregnancies were within the last 5.5 years. I did go on progesterone with two of those pgs too - the two that stuck. So, I have a hunch I'll be put on progesterone again. (Progesterone was an 18 when pg with my daughter, which is high enough in general but not as high as my dr liked. It wasn't tested when pg with my son. It was a 25 during my 3rd miscarriage which is actually a pretty good number).

Add in that I get very sick when I get pg - even when I miscarry - and I'll have to ask my dr about phenergan and zofran and any interactions. I'm very nervous after reading that dehydration increases clotting since I get that within a week of a positive pg test!

Just to complicate matters a little more, I'm still breastfeeding. I asked three drs and was told the baby aspirin is fine. My daughter is 22 months, so I'm not overly concerned since I can time the aspirin so she doesn't nurse for several hours after I take it. I read that heparin is fine when nursing but haven't found anything to say if lovenox is as well.

I'm quite nervous about needing a repeat c-section too. (The two who made it needed c-sections in case you hadn't guessed that!) I'd actually love to try a VBAC but I don't think any dr would let me. And realistically, I don't know if I can grow a normal sized baby. I'm hoping the risks for c-section with FVL are greater than risks for VBAC after two c-sections. But I'll worry about that closer to the time! I have to get pg first!

So, please share with me what your dr said to do if your situation is similar to mine - no clotting, miscarriages, healthy births as well.

Tricky_Tink - Feb 15th, 2008 9:42 AM

Hey Kohlby,

I am right there with you. I am positive for FVL, no history of clots and several m/cs. Mine went sucess, m/c 12 wks, m/c 8wk, m/c 4wks.

Right now I'm taking one baby asprin a day. OB will put me on Lovenox when a pg is confirmed.

I am also 5'1 and all of 107lbs. My baby was much smaller though 6.6lb and vaginal. In my opinion your not missing much by having the c-sec's. Less recovery I guess, but I was ripped pretty bad and well it don't look the same down there anymore! :(

I too am trying to get pg. So good-luck to us both!

Baby Dust to you,
Tammy


kohlby - Feb 15th, 2008 12:57 PM

After a lot more testing, it's been discovered that I have insulin resistance. So, I'm on a diabetic diet for life as of a week ago. I talked to my RE and she (and her collegues, they discuss cases together), don't think the FVL caused my miscarriages due to insulin resistance being a more likely cause. (My level was supposed to be 18 or below and it was 37! The other choice was metaformin but I chose diet) I'm on a baby aspirin a day but no lovenox. I found out I was pg again two days ago so I'm on vaginal progesterone twice a day now too. It's never been proven that I have low progesterone but I was on progesterone for my two other pgs that made it, so it can't hurt!

*I can't agree with you that vaginal isn't better! My first c-section hurt so much that I couldn't even diaper my baby for over two weeks. I was incapable of caring for him due to the pain level all that time. I don't look the same down there anyways, due to vulvar varicosities when pg with my second child.


kohlby - Jan 25th, 2009 9:28 PM

I figure I should update! Since my last post, I had my 5th miscarriage. That baby was tested and had perfect chromosomes. I then demanded to do Metformin and to stay on it as long as possible. I got pg again - and stayed pg! It was also found later that I have MTHFR hetero but it was somehow lost between all my drs. I've been seeing a perinatologist quite often during this pg and she's the one who retested me for MTHFR. So, I'm on twice daily heparin injections due to the combination of MTHFR and FVL.

I'm now 34.5 weeks pg and growing a healthy baby boy! I'm a bit nervous about the chance of going into labor before my scheduled c-section, but thrilled to have made it so far! To add to my story, my husband had testicular cancer since my last post and this baby was concieved 4 weeks after one testicle was removed and just a day before he had chemo. He's fine, thank goodness! But this really is our last chance baby and it's actually working out!


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