Continue lovenox

lennasingh

6 Posts
Reply Posted on: Apr 17, 2012 at 5:08am
Dear Dr. Braverman,
I have completed 12 weeks after 4 early miscarriages. This is a natural cycle on neupogen.
I do not have any known blood clotting issues however I insisted on being prescribed lovenox after confirming pregnancy. I am on 40 mg lovenox once a day. I am also on 75 mg baby aspirin and fish oil.
Now my ob wants me to be off lovenox. In the beginning of my pregnancy, when i was being monitored for blood flow to the uetrus, the resistance index was coming high at 0.8 and 0.7.
Now it is at 0.5
My question: Do i need to conitnue with lovenox?
If yes, till how long?

Please advise.

Thanks a ton!
Lenna

Dr. Braverman

2016 Posts
RE: Continue lovenox Posted on: Apr 17, 2012 at 6:37am
was thrombophilia performed if so what were the results? you can email me privately for this.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

lennasingh

6 Posts
Reply RE: Continue lovenox Posted on: Apr 19, 2012 at 3:56am
Dear Dr. Braverman,
I would like to email you privately but somehow whenever I have emailed you directly, I never get a response from you. I suspect that my emails are goign to your junk/ spam folder.
Anyway, to snwer your query, "was thrombophilia performed if so what were the results? you can email me privately for this."

the varius blood tests ordered for clotting issues over the last few years by my doctor and the results are as follows:
Blood test taken on - 30Jan 2009
1. Lupus Anticoagulant Panel (LAC)
On control blood - 34.89 sec
On Patients blood - 35.10 sec (range is 28.65-41.13)
PTT-Lupus Sensitive - 31.7 sec (range is 31.40-43.40)

2. LAC by Dilute Russel Viper venom - No lupus like anticoagulant present
3. Antinuclear antibody/ Factor (ELISA) - negative
4. Ant-ds DNA antibody - 8.98 (range is below 35 is negative)
5. Anti Cardiolipin Antibody (aCL), IgM - 2.23 (range is below 10 is negative)
6. Anti Cardiolipin Antibody (aCL), IgG - 9.51 (range is below 10 in negative)

Blood test taken on May 2009
1. Homocysteine, quantitative - 9.5 (range is 4.6 - 12.44)
2. Protein C Activity, Plasma - 115 ( range is 67-195)
3. Protein S Activity, Plasma - 57 (range is 55-123)


other than that I regularly track my wbc and platelets since i was on neupogen. the latest results for wbc is 22 while platelets is 100,000

Would really appreciate if you can offer me advise on next steps.
Thanks,
Lenna

Dr. Braverman

2016 Posts
RE: Continue lovenox Posted on: Apr 19, 2012 at 6:07am
At this point with good uterine flow and no obvious thrombo findings I can see why your OB wants to stop the lovenox and I see litte risk in doing so.

Please send me a test email today, I want to clear up the reason as to why we are not getting your email , I havent seen any in our Spam folder.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

lennasingh

6 Posts
Reply RE: Continue lovenox Posted on: Apr 20, 2012 at 1:53am
Dear Dr. Braverman,
I just sent a test email. Hope you receive it.

I had my ultrasound today for blood flow. The Resistance Index is 0.5 on my right side and 0.7 on my left side. The doctor said that anything below 0.8 is fine and I must get off Lovenox after doing it twice for another week.

Everythign else is going well with the pregnancy.

1. Is it safe to get off lovenox? I am very scared

2. Do I need to continue monitoring blood flow throughout the pregnancy

My doctor is now releasing me to a regular oby/gyn.

Thanks a ton!
Lenna

Dr. Braverman

2016 Posts
RE: Continue lovenox Posted on: Apr 20, 2012 at 8:09am
with a normal thrombophilia and now normal Resistance Index studies I would not be concerned at 12 weeks in stopping the lovenox as your doctor wishes. Please be aware of course that I have not seen you and had a consult so I have to caution that the final determination for all treatment must rest in the hands of the doctor who is seeing you.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.