Expert: Lawrence Jay Rappaport <B>M.D.</B> - 10/24/2005
Question Dr. Rappaport:
I am a 32-year-old mother of 3 (11, 4, 17 months) and I am currently pregnant. I had a DVT in my left lower leg 2 1/2 years ago. I recently felt a similary feeling in the same leg and was sent for a venous study. At the time, they thought that I had another. A ton of blood work was done and we found out I am pregnant. I was admitted and put on IV heparin. My blood went to a critical level (APTT >212.0 norm range is 22.8-32.0). Could this have an effect on the unborn fetus? It was very early on, the HCG-serum quant was 52.0 MIU/ML. I am also + for lupus anticoagulant and anticardiolipin antibodies. I am using Lovenox 40 mg qd. Every muscle in my body hurts. I cannot walk for a while (10-15) after sitting or sleeping without so much discomfort that I start crying. I am still waiting to see my OB, I don't see him until 11/8, my PCP says I am out of his league, the pulmonary and heme Dr.'s said my OB needs to answer these questions. Help. Thank you. Kristen
Answer As you know, DVT is a serious condition. HOwever, as long as you maintain your status, you should be able to go through the pregnancy without problems. Continue the Lovenox every day and call the hematologist if you have pain in your legs (The dose may have to be adjusted). The condition or the medications will not cause any harm to the fetus. However, if you have positive lupus anticoagulant or anticardiolipin antibodies, there is a higher risk for miscarriage or stillborn. This is not a reason to terminate the pregnancy. Just monitor very closely and keep in touch with your obstetrician as well as your hematologist.
