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    When are Lonopin shots advisable during pregnancy?

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Posted on Tue, 24 May 2016 in Pregnancy
Question: Hi,
I wanted to ask a question on when to start taking Lonopin 40mg injections during pregnancy.
To brief you about my history:

I had two back to back missed abortions. D&E was done in 9th-10th week.
In both case there was a heart beat at 6 week ultrasound and during D&E fetal growth corresponded to 6 - 7 weeks.

So doctor was on the opinion that some blood coagulation was causing choke in the blood supply to fetus and
recommended Lonoping Inj 40mg along with ecosprin 75mg tablet daily for next pregnancy.

So in third pregnancy doctor started this treatment right after +ive home test ie around 4 1/2 weeks.
The pregnancy was successful and I delivered a baby via C-section on 37th week.

Now I am again pregnant at 5 weeks now.
This time doctor wants to start the lonopin injection only after a viable heart beat in ultrasound.
Which is around 6 1/2 weeks.

So I just wanted to know that waiting this late to start same treatment this time is OK.
What if blood starts coagulating and we don't have a (healthy) heart beat at 6 1/2 week ultrasound.

Is lonopin responsible for initial healthy fetal development.
What is usually the ideal time to start this treatment for cases of recurrent missed abortion.

Just to note that my all blood tests like APLA panel, TSH, Abnormal Hemoglobin, Torch panel and other routine blood tests are all normal.
I am B-ve and my husband and baby B+ive.
I have been given Anti D injection for the same in all cases.

Would appreciate if you can resolve our doubts on lonopin treatment as mentioned above.

Thanks
XXXXX
doctor
Answered by Dr. Deepti Verma 36 minutes later
Brief Answer:
Lonopin not indicated

Detailed Answer:
Hi dear,
I have gone through your question and understand your concerns.
If your APLA is negative, then there is absolutely no role of lonopin injection in your case.
However, even then if your doctor is willing to start it, then it should be started only once the cardiac activity appears on the ultrasound, as lonopin has no role before that.
Aspirin daily is adequate treatment to maintain the blood flow to the fetus.
Hope you found the answer helpful.
Regards
Dr Deepti Verma
OBGYN
Maternal and fetal medicine specialist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Deepti Verma 21 hours later
Dear Madam,
Thanks for the reply.
Yes our doctor also told that since APLA is negative I don't actually fit the profile.
However since my second pregnancy also resulted in missed abortion with same pattern as first one, based on doctor's opinion and past experience, sometimes APLA gives negative result, but if there are recurrent missed abortions then lonopin is prescribed to be on safe side.

It is clear to me now that based on my case, it makes no sense to start lonopin before cardiac activity is established.

Regards
XXXX
doctor
Answered by Dr. Deepti Verma 13 hours later
Brief Answer:
Happy to help

Detailed Answer:
Hi dear,
I am happy to have helped you.
Yes, some doctors do start lonopin based on the history even if the APLA is negative.
Regards
Dr Deepti Verma
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Deepti Verma

OBGYN, Maternal and Fetal Medicine

Practicing since :2009

Answered : 5068 Questions

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