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When Are LMWH Injections Stopped Before Delivery?

Posted on Wed, 21 May 2014

Question: Hello doctor,
Im curently 5 months pregnant (19 weeks completed) and taking LMH(low molecular heparin)4ml daily once.My doctor suggested this as i had conceived earlier and got faint positives twice,each time followed by period around 6 weeks.My apTT was 46 secs.
I would like to know how many weeks before delivery will they stop this injection and will i be able to have a normal delivery?also why exactly am i being given this medication.everywhere i read i net it says delivery will most probably be induced and timed too avoid comlications. please clarify

Answered by Dr. Manisha Jain (1 hour later)

Brief Answer:
LMWH is given till delivery

Detailed Answer:
Hello XXXX thanks for trusting health care magic.
This LMWH is prescribed in pregnant patients with bad obstetric history and especially who have had unexplained pregnancy losses in past.
It is used world wide for this indication.

This injection will be administrated to you till the day of your delivery and will be stopped 12 hours before induction of labor pains and 24 hours before planned cesarean if required.
It is a safe injection and helps in continuation of pregnancy as you can see the progress in your case.

Your delivery route will not be guided by the fact that you are having this injection but definitely extra precautions will be taken because its a precious pregnancy.
Induction of delivery will be done in case you don't start labor pains spontaneously on due date because there is no point in wait and watch approach.
So relax because everything is planned in optimum way and is up to the mark.
In case you have any other question I will be happy to help.
Dr Manisha XXXXXXX
(High risk pregnancy specialist)

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Manisha Jain (27 minutes later)

doctor,
thanks alot for your clarification.In case labour pain starts before due date while im on the injection will there be complication in normal/caesarean delivery?will i be able to have a normal delivery if at all my pain starts naturally anytime around due date?
I will be switching to another doctor as my delivery will be in my native.will each doctor handle it differently?my neighbour was pregnant just like me but they stopped her injections 2 weeks before due date.

Answered by Dr. Manisha Jain (10 minutes later)

Brief Answer:
blood components given, easily available.

Detailed Answer:
Hi dear, firstly I would like to appreciate your insight of the questions you have posted so far.

In case pains start themselves before due date and you are still on injections, then doctor will see the opening of your cervix and thus assess the approximate time in Delivery of the baby
- if more than 12 hours then nothing to worry
- if within 12 hours of injection then a blood component is injected into the patient which is readily available in all blood banks and is harmless.

All doctors follow same regimen as I have worked in 3 different hospitals with critical obstetric care and all were following same protocol.

I wish you the best of health and may God bless you with a healthy baby soon.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Manisha Jain (11 minutes later)

Thank you doctor i tend to read alot.thank you again for your detailed clarification and patience.Thanks a lot for your wishes

Answered by Dr. Manisha Jain (4 minutes later)

Brief Answer:
Take care

Detailed Answer:
My pleasure XXXX.
Its really nice to deal with such well informed patients.
Take care.

Above answer was peer-reviewed by : Dr. Shanthi.E