Pregnancy

[katiewintle]

Just after some advice. I am on warfarin for life as I have a mechanical heart valve. When planning a pregnancy will I have to have heparin injections for the whole 9 months or just for the start of the pregnancy? Is their an alternative to heparin injections as I cant stand the thought of injecting myself everyday. My INR needs to be between 3 and 4, ideally 3.5. I am stable at the moment around 3.7ish.

Any advice appreciated, I am all new to this!

Katie
xx

 

[Ross]

Katie I would highly advise against pregnancy will being anticoagulated. I know, it's probably too late right?

Anyhow, your going to need a team of very highly specialized doctors to get you through this successfully. Heparin has nothing to do with INR. What you'll get is most likely Lovenox, which is low molecular weight heparin and each dose is good for 12 hours. Do not underestimate this drug. It is highly anticoagulant, more so then Coumadin. I can't remember what the starting and stopping points are during pregnancy, but I'm sure someone will let us know. It's very dangerous for you and the baby, so don't let just any old doctor treat you. This MUST be handled with a fully skilled team of doctors.

 

[TXGal]

Katie,

Are you already pregnant?

 

[Maryka]

Yow! Hoping you are not already pregnant! Most of us take so many heart meds that could cause birth defects. Add to that the many dangers of anti-coagulants in pregnancy and OMG! Of course, I know a young woman who was a cocaine addict and an alcoholic throughout her pregnancy and managed to give birth to a 5-pound seemingly healthy girl (who is still seemingly healthy at age 4). Miracles can happen, but, please talk to lots of doctors before getting pregnant!

 

[fischje]

I was advised by my surgeon and cardiologist that I wouldn't be able to carry a child. Even though lovenox can be an alternative he said there is no way to measure that I would be anti coagulanted enough to ensure my safety of the child and myself. It is still something I struggle with that I will not have my own child

 

[Ross]

Now this is new to me. They are now thinking maintaining oral anticoagulation is safer then using heparin:

Gotta love the internet for conflicting reports: http://www.ccjm.org/content/76/2/113.full

 

[katiewintle]

I am not pregnant! I have a heart check-up in August and am considering my options regarding children. I know I need to talk to my cardiologist etc first.

 

[Ross]

I am not pregnant! I have a heart check-up in August and am considering my options regarding children. I know I need to talk to my cardiologist etc first.

Whew, scared me a bit there.

 

[Luana]

Kristen,
Couldn't help but notice in your signature, looks like you had a baby with a mechanical valve. How did you manage ACT during pregnancy?

 

[ALCapshaw2]

Two Alternatives come to mind:

Adoption and Surrogacy.

I'm thinking that there have been *some* pregnancies while anti-coagulated but it is considered to be Very High Risk.

Should you choose to carry a child while anti-coagulated, you would be well advised to engage the services of a High Risk Obstetrician and an Very Well Informed Anti-Coagulation Manager (Doctor and/or Nurse) with Experience supervising pregnancies while anticoagulated.

 

[TXGal]

Luana, I had my 2 1/2 year old through surrogacy. I was told by my cardiologist that he'd follow me through my own pregnancy if I wanted to, but he strongly recommended that I talked to Mandy, a woman in my same town who had a mechanical valve and decided to get pregnant. Here is her story:

Mandy's Story I posted March of '09: http://www.valvereplacement.org/for...hanical-valve-story&highlight=mandy+surrogacy

I decided after talking to Mandy that there are too many possible complications with pregnancy and my mechanical valve and wanted to make sure I was healthy enough to be around for my baby after he was born. It's completely up to you, but I really don't recommend getting pregnant. If you have any questions about surrogacy let me know.. I know of some great websites.. Gnusgal is a member on here who has twins through surrogacy as well.. of course adoption is another option as well.. best of luck on whatever route you choose! I'm here if you have any questions!

Few other links on the boards about pregnancy and coumadin, please read:

http://www.valvereplacement.org/forums/showthread.php?t=23884&highlight=willow

http://www.valvereplacement.org/forums/showthread.php?t=23203&highlight=willow

 

[Lynlw]

Now this is new to me. They are now thinking maintaining oral anticoagulation is safer then using heparin:

Gotta love the internet for conflicting reports: http://www.ccjm.org/content/76/2/113.full

I'm a little confused how the study from 2002 about pregnancies from 89-98 is still the current, but they say it is.. I did see that 3 (out of 29) of the children that survived ended up with the facial deformities that is one of the reasons they don't advise coumadin thru out the pregnancy.

 

[Ross]

I'm a little confused how the study from 2002 about pregnancies from 89-98 is still the current, but they say it is.. I did see that 3 (out of 29) of the children that survived ended up with the facial deformities that is one of the reasons they don't advise coumadin thru out the pregnancy.

I'm confused too. I do know that heparin is far more dangerous then coumadin, but they are only now beginning to see the light. As far as pregnancies go, the whole affair is dangerous to both mother and fetus. It can be done, but you need the top of the line doctors as a team approach and frankly, when it comes to anticoagulation, there isn't much to choose from with any real knowledge out there.

 

[Luana]

Luana, I had my 2 1/2 year old through surrogacy. I was told by my cardiologist that he'd follow me through my own pregnancy if I wanted to, but he strongly recommended that I talked to Mandy, a woman in my same town who had a mechanical valve and decided to get pregnant. Here is her story:

Mandy's Story I posted March of '09: http://www.valvereplacement.org/for...hanical-valve-story&highlight=mandy+surrogacy

I decided after talking to Mandy that there are too many possible complications with pregnancy and my mechanical valve and wanted to make sure I was healthy enough to be around for my baby after he was born. It's completely up to you, but I really don't recommend getting pregnant. If you have any questions about surrogacy let me know.. I know of some great websites.. Gnusgal is a member on here who has twins through surrogacy as well.. of course adoption is another option as well.. best of luck on whatever route you choose! I'm here if you have any questions!

Few other links on the boards about pregnancy and coumadin, please read:

http://www.valvereplacement.org/forums/showthread.php?t=23884&highlight=willow

http://www.valvereplacement.org/forums/showthread.php?t=23203&highlight=willow

Wow, Mandy sure had a story. I'm glad you didn't attempt it and wish all the best in good health to you and your family!

 

[Lynlw]

I'm confused too. I do know that heparin is far more dangerous then coumadin, but they are only now beginning to see the light. As far as pregnancies go, the whole affair is dangerous to both mother and fetus. It can be done, but you need the top of the line doctors as a team approach and frankly, when it comes to anticoagulation, there isn't much to choose from with any real knowledge out there.

And even with a team of the very best doctors, it is still dangerous, look at Willow, who had a team of the best and consulted with the top doctors all over and still had life threatning problems, even tho Thankfully both her and the babies (2 different pregnancies) survived

 

[TXGal]

Wow, Mandy sure had a story. I'm glad you didn't attempt it and wish all the best in good health to you and your family!

Thank you!