Wednesday, June 4, 2014


My OB appointment went well, she decided to wait until next week to do the internal check and swab. Baby B has it's head to my right now, rather than left, but is still transverse up top. Baby A is still breech on the right. We only have 3 more OB appointments before our scheduled c-section, assuming we make it that far.

I did discuss some concerns with her and went over the risks with staying on Lovenox. Lovenox is great if you need it, really it is, but it doesn't come without risk. One of the obvious risks is hemorrhaging. One of the less known is the risk of becoming paralyzed from a spinal hematoma in the event that you need to deliver with a spinal/epidural before it's out of your system.

Basically that won't be an issue if we make it to our scheduled c-section. I would just skip my dose the night before, and my system should be clear for a spinal. The issue comes from spontaneous labor, which is a real possibility since I'm carrying twins and my c-section isn't scheduled until 38w4d (average delivery for twins is 35w, most happen before 37w). If I go into labor spontaneously the hospital will have to look at when my last dose was; Lovenox can last up to 24 hours in the system but it might be safe after 12 hours for me since my dose is low/preventative. They'll then have to do blood work to check if it's safe or not. If it's been long enough, or blood work shows it's safe, then I can have the spinal and that's alright. If it's NOT though, I will need to have my c-section under general anesthesia. Which means that neither A or myself will be "present" or "awake" for the birth of the twins.

Last time we switched to Heparin later on, since it can be reversed and doesn't last as long in the system. Lovenox is once a day, while Heparin is twice a day (since Lovenox lasts 24hrs, Heparin lasts 12hrs). This time my OB and MFM would rather keep me on Lovenox. Lovenox is safer in pregnancy since it's low molecular weight, so it stays more stable in the body. Heparin is safer for delivery though. My OB did say they could switch me to Heparin if I wanted, but we opted to just stay on the Lovenox since it's safer overall (not to mention I am running out of non-bruised places to inject as it is). I just have concerns about it and worry about delivery. I'm trying to wrap my head around the possibility of having to deliver under general anesthesia- I know that there's a chance that may not happen, but I'd rather mentally prepare just in case. It's really hit or miss how things will go down.


MrsSpock said...

I hope you get to be awake to see those babies born!

alphakirby said...

It would be great if you were awake to see the babies born. But...more than anything, I hope all 3 of you are healthy and well! Can't wait to see these little bundles!! They are already receiving much love and good wishes!!

Rebecca said...

Understandable how you feel. I'd want to be awake for the birthing too. said...

If you start to feel labor symptoms will they allow you to stop injections? I ended up stopping my shot on Monday. I did mine around 3pm daily. I had my OB weekly visits on Tuesdays and I was 4cm at the appointment. I was scheduled to be induced on Thursday that week. Since I was feeling so crappy I didn't do my shot and went to the hospital where I was 5cm. They tried sending me home which was amazing.

Anyway, I guess what I'm asking is, when are your weekly check ups? Are you dilating at all? Will they let you stop the lovenox if you're thinking you're in labor?

By the time I was actually admitted to the hospital it had been 32 hours since my last shot. By the time I got the epidural it was 36 or so hours.

AnotherDreamer said...

Well, last time I was in active labor so I didn't take my Heparin dose that day. If I'm having contractions and suspect that I'm in labor, I would skip my dose until we confirm either way, but since I take it every 24 hours it's still a pretty big window. Last time my water broke and I immediately started having contractions 4 minutes apart, my body didn't really gear up so much as just jumped right in. So we might not have a lot of warning again.

They'll begin cervical checks at my next appointment (Tuesday) but I really don't know how telling they'll be? I was only 1cm when my water broke with V, and that happened the day before my scheduled induction. My body just wasn't cooperating or giving anything away!

Celia said...

I am thinking of you, hold on! I am so excited for you. I will be stalking your blog gumdrop.