heparin and warfarin

I am 27 and underwent a liver resection in January 2004. After surgery I developed bilateral DVT in my legs and later developed a PE at this time an IVC filter was inserted. The Physician that placed the filter told me and my husband that the filter was a retrievable filer and that because I was so young and wanted to have children after I was on coumadin for a while and after the clots resolved they would go in a retrieve the filter. After about three weeks they went in to remove the filter and found out that the filter was stuck. They have tried twice to remove the filter but have been unable to do so and have since said that the filter has become permanent. My husband I are wanting to have a child. Will this filter cause any problems during pregnancy?

Ryan

Retrievable filters are rather new and there is little information on the optimum use of them. They have been used recently because sometimes, a long term filter is NOT needed and also because if you have a filter, long term blood thinners are necessary to prevent clotting from occurring around the filter. Retrievable filters show much promise. However, just as any device, once something is inserted into the body, tissues grow over it and sometimes it becomes part of the body and is more dangerous or impossible to remove. This is what sounds like happened to you.

Persons on warfarin should not get pregnant because warfarin is harmful to the developing fetus. Therefore, persons who are on warfarin for a clotting condition and must remain on a blood thinner, will need to be placed on a heparin medication when they become pregnant or even when they decide they are going to try to become pregnant, and continue on this medication until the fetus is developed enough not to risk harm to it's growth. It makes things more cumbersome, however it does not preclude having a child that is normal.

It is important for anyone on warfarin to use birth control. Once you consider becoming pregnant, you must speak to your doctor before you become pregnant so that precautions may be taken to ensure a healthy child.

Good luck to you.

I have a question regarding my husband who has been to the Mayo Clinic and diagnosed with anticardiolipin antibodies. He has been on coumadin for this disorder and cannot handle taking this medacin. He gets very light headed when on it, sick at his stomach, weird feelings that come over him that makes him break out in a sweat. He has also taken Lovenox injections which are to expensive to be on a daily basis. My question is: Is there any other time of medicine he can take to prevent him from having a blood clot occur? Meaning is there any other kind of medicine that will work to thin his blood?

Heparin and Warfarin have been used for many years. There is much research in this area in an effort to find newer safer and easier medications. Much of these medications are based upon new medical technology and many are based upon nature. While there is currently no FDA approved medication to replace warfarin, much research is ongoing and promising studies have been completed. Please see our page on research projects regarding the new thrombin inhibitor that we have had experience with. Updates on this medication are posted regularly and when it becomes available it too will be noted on our web site under newsworthy. Our hope is that these new agents will not require frequent monitoring, will be safer, and will be taken as a pill.

I got a DVT in my left leg while I was in the hospital having an
operation on my intestines which had become blocked due to adhesions. I
have been on Warafin now for 6 months and just had a Doplar done on my
leg and was told I still had residual effects from the clot. My
question is how long do I have to stay on Warafin? I will be seeing my
Dr. soon and was just wondering what the general consensus on this is
as I really don't want to be on any long term medication. My leg does
not hurt and is not swollen. Thank you

This question has been well studied in thousands of patients. We know that after one blood clot, six months of therapy with warfarin is necessary. However, there is some investigation ongoing that may change that and in the future it is possible that longer durations of therapy may be recommended.

There is some investigation that demonstrates that persons who develop blood clots because of reversible factors may require shorter durations of therapy, six weeks to three months. This includes people that develop blood clots because of trauma or surgery that do not have an inherited predisposition to the development of blood clots. You may fit into this category depending upon your medical history and laboratory testing.

If you look at ultrasounds in patients that have had one blood clot, at one year, a majority of them are NOT normal. There is the development of new blood channels for the blood flow. Therefore, typically, a repeat ultrasound examination is not recommended unless there is evidence of complications. In many of the research studies, repeat imaging studies are NOT done. Therefore, I would not be concerned regarding your recent doppler examination.

I am 32 weeks pregnant and recently diagnosed with two pulmonary emboli, both in the Pulmonary artery (one in left branch, one in right). My pre-preg. weight was 125, now 148. I am self-injecting Lovenox q 12hrs, 60 mg syringes. I am told I will be having a regular vaginal delivery. I would like to have an epidural, but since I don't know when the baby is going to come.....I can't possibly plan to take my last dose 12 hours before labor- are there other options such as inducing labor or planned c-section?

This is an excellent question and one that has not been well studied as it is not easy or ethical to do studies on pregnant women in the United States.

Lovenox when used within twelve hours of epidural anesthesia has been reported in several cases to result in bleeding. Bleeding into the spinal cord may result in paralysis, therefore this is a significant concern. Because of this, recommendations are that the last dose of Lovenox be 24 hours prior to any epidural procedures.

Some obstetricians have induced labor in your situation. In some centers, labor is induced just for ease of scheduling in patients without medical conditions, therefore this is not that new. If labor is planned, then the Lovenox can be safely stopped and induction began so that delivery coincides in 24 hours allowing epidural anesthesia. If you desire an epidural, this may be your best option. Remember to discuss risks of induction with your obstetrician before making any decision.

A C-section is not often needed and involves cutting to remove the baby with a resultant recovery period and therefore would not be the best option in this situation as it results in unnecessary surgery.

I am 11 weeks pregnant. At 8 weeks I had extensive bloodwork done due to the regular tests and that my mother has sytemic lupus and polycythemia vera. My doctor said that I tested positive for the antibody against autoimmune disease and that I have a "bad gene" for being at high risk for blood clots. Anyway, I am taking 30 mg of Lovenox evey 12 hours by self injection. I want to know the risks to my baby and to me. I also would like to know any info you may have on my mother's disease being hereditary.

It is difficult to answer your question, as there are many genetic abnormalities that your doctor may be referring to. Some have greater risk of problems and some less. If you look at the pages on the web site under clotting disorders, many of the more common disorders are listed with explanations.

As for the Lovenox. While it is impossible to test pregnant women to see if there is any affect on their unborn child, this is unethical and not allowed by the FDA, this drug has been used by many pregnant women and there are no reports of ill affects on the unborn child. Some believe that heparin products may even be useful in women with difficulty conceiving.

Send mail to rshtcn@aol.com with questions or comments about this web site. Last modified: March 02, 2008

Send mail to rshtcn@aol.com with questions or comments about this web site.
Last modified: March 02, 2008