Blood Clots During Pregnancy

Deanne Stein Health Guide
  • The daily routine of putting two injections in my stomach is really getting old.  Some days it goes very smoothly, but some days I psych myself out and it takes several stabs to get it right.  What gets me through this routine is the fact it keeps me alive and my baby girl, hopefully, will be healthy.  Don’t get me wrong, I’m counting the days until my baby’s birth when I can switch back to my oral blood thinner Coumadin.

               

    The injections are Lovenox, which I’ve written about before.  By giving injections rather than swallowing a pill, the blood thinner doesn’t cross the placenta, which is safer for the baby.  The injections are also necessary for me so that I don’t develop any blood clots, which could result in another stroke.  The downside of doing injections, other than the annoying jab to the belly everyday, is that I can’t have an epidural during labor.

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    Since my pregnancy is high risk, I have three doctors on my case.  While my high risk OB says I could go off the Lovenox 24 hours before giving birth, my neurologist says NO.  That’s because he told me the risk of developing a potentially deadly blood clot is much higher not only in a pregnant woman but one who is in labor and even afterwards during early postpartum.

               

    If I have an epidural while on Lovenox, there is a chance I could have problems within my spine and while rare even suffer paralysis.  I could have a C-section and be put under altogether, but doctors say they would only do that in an emergency because of the risk of bleeding.  So it looks like natural labor for me. Oh boy, looking forward to that!

               

    The reason some people have a tendency to clot is because they have thrombophilia.  People with this condition tend to form blood clots too easily.  It can be because their bodies make too much of a certain protein or too little of anti-clotting proteins that limit clot formation.  One in five people in the United States have thrombophilia.  Some people don’t even know they have it.  Often the clots form in the lower leg area.  Symptoms include swelling, redness and discomfort.  Sometimes the clots break loose and travel through the blood stream.  When the clots block blood vessels in the lungs, brain or heart, it can cause a heart attack or stroke.

               

    Pregnancy is a time when thrombophilia is more common.  However, most women with it have healthy pregnancies.  Complications include stillbirths, placental abruption or poor fetal growth.  That’s why it’s best to talk to your doctor about the condition especially if you or your family have a history of blood clots and stroke.

               

    If your doctor puts you on bed rest or if you are recovering after delivery, there are several in-bed activities you can do to promote circulation in the lower legs to try and prevent a blood clot.  Check with your doctor first before trying these.

    • Ankle Pumps: Lying down with legs extended, move your foot and ankle up and down for 10-15 repetitions; repeat with opposite leg. Do one set every hour.
    • Ankle Alphabet: Trace the alphabet with your foot. Think of your big toe as chalk writing on a chalkboard.
    • Side-lying Leg Lifts: Lying on one side, exhale and lift your top leg 10-12 inches; inhale and lower leg. Do 15 repetitions on each side.
    • Quad Stretch: Lying on one side, bend top knee and grasp ankle with your hand; pull foot toward your buttocks until a stretch is felt in the front of the thigh. Hold 15-20 seconds and repeat on opposite side.
    • Calf Stretch: While sitting upright with legs extended in front of you, place a towel around the ball of your foot, holding onto the towel with both hands. Keeping legs straight, pull your toes towards your nose until you feel a gentle stretch in the back of lower leg. Hold 15-20 seconds.
    • Hamstring Stretch: Sit up straight, with legs extended. Lean forward over your legs, keeping your torso tall, until you feel a gentle stretch in the back of your thighs. Hold 15-20 seconds.
    • Seated Leg Extensions: Sit at the edge of the bed, placing a rolled towel or pillow under your knees (legs should be hanging down off the bed or touching the floor). Exhale and straighten one or both legs until they are straight; inhale and lower. Repeat 15-20 times.
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Published On: July 02, 2007