PE and pregnancy
Looking for advice on the risks and management of pulmonary embolisms (PE) in pregnancy. Over the weekend, doctors discovered that I have a small PE that we are now aggressively managing with Eliquis. My husband and I have been trying to conceive our second child, and we are getting mixed advice about whether to hold or not giving this development. While very scary, I know that PEs can happen and be managed during pregnancy. I also know that Eliquis is not known to be safe during pregnancy, but that other blood thinners may be? Would appreciate hearing from other parents who have navigated something similar and recommendations for what kind of specialists to speak with. Thank you.
Oct 3, 2023
Parent Replies
Not sure it is directly comparable, but I injected myself with heparin when I was at risk for clots when I was pregnant. To my knowledge, heparin is safe during pregnancy. I had an OB for high risk pregnancy because of age, twins and was immobile from injury. She ordered the heparin.
I have a long-known blood clotting disorder, and have been on blood thinners since I was a teenager (medical history includes a number of DVTs & PEs). For pregnancy I was put on lovenox (which had to be approved by my insurance, as it’s an expensive medication) as by my hematologist. My understanding is that this is the preferred blood thinner for pregnant people, as it has been shown to not cross the placenta/have impacts to the embryo/fetus’s the major downside of lovonox, besides the cost, is that its delivery mechanism is self-injection (and it sometimes burns/hurts during that injection). I initially was put on a daily injection, which was upped to twice a day when I clotted on the single injection.
I’d highly recommend finding a hematologist to discuss your options with (one not focused on blood cancer). I discussed my hematologist (and experience in the UCSF medical system for maternal care) in the recent question here on BPN called “High Risk OB Recommendations?” - in short, I greatly appreciated the care I received, particularly from my hematologist Dr. Andrew Leavitt, who is the best medical professional I have ever interacted with, hands down. Glad to chat more, if you’d like.
I believe you are looking for someone who specializes in oncology/hematology.
Lovenox is a popular blood-thinner used during pregnancy. But it requires daily injections.