Talk to Gynecologist on Anticoagulant Without Antiphospholipid Antibodies?
Asking for Wife, Female, 31 years old, Karachi
My wife had one miscarriage in 20 weeks in first pregnancy. 2nd pregnancy we got a son Alhamdulillah. 3rd pregnancy we lost a son who was born but premature in full term, it was IUGR. Now it is 4th pregnancy, doctor advised antiphospolipid antibodies test, came negative, see attached.
Without further investigation the doctor has advised Heparin therapy and advised 40mg Clexane inj daily for 8 months.
Having read the conflicting clinical trials reports I am not convinced it to be effective and whether my wife has any DVT related problems which is clear from the test results attached.
I am considering a second opinion and wish to know if my concerns are right or I am just over reacting? As a father I just don't want this pregnancy to go wrong.
Dr. Anila Rehman - Gynecologist
| MBBS | FCPS (Obstetrics & Gynecology)| | Karachi
15 Positive Reviews
your concern is right can i know whats her gestation now and in last pregnancy was therer any ra8sed bp
Dr. Naheed Akhtar Rana - Gynecologist
MBBS, MRCOG (Obstetrics & Gynaecology) UK, DFFP (UK), FRCOG (UK) | Lahore
369 Positive Reviews
No the pattern of pregnancies is not like thrombophelia , in this pregnancy keep her on loprin and fetal growth scans should be done every3 weeks from 24 week on wards keep doing the Doppler studies as well , the growth ultrasound should be done by one good ultrasound specialist so that various operator error is not there. She needs to be under care or a competent obstetrician
Patient
Post Owner
She is already on Duphaston, Ascard 75 mg & folic acid.
Any competent obstetrician recommendation in Karachi?
5 years ago
Assalam o alaikum.
laboratory criteria for APLA is not fulfilled so don't start inj clexane.
what about blood sugar level?
you need to keep blood pressure records in this pregnancy also.
any complain of vaginal discharge?or bleeding?
any thyroid problem?
take ascard 75 mg,folic acid daily,
healthy diet and stay well hydrated.
growth scans should be done in this pregnancy due to last iugr
.
Patient
Post Owner
Walaikumsalam, when you say growth scans, does it mean normal ultra sound or any special scan that is not normally done? the ultrasounds were regularly done but I doubt the scans were good enough, I came to an understanding after this discussion that the ultrasound plays a great role in assessing the case so I am willing to do the best possible ultra sound, any recommendation?
5 years ago
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Patient
Post Owner
Last LMP is 3rd Feb.
30th March scan shows 6week +2 days gestation.
No history of raised BP except one time blood came from nose during last pregnancy.
5 years ago
| MBBS | FCPS (Obstetrics & Gynecology)| | Karachi | Book Appointment
dont give clexane and heparine as nothing suggest thrmbophilia and start ascard 75mg daily and continue foluc acid she will need frequent scan after anomaly scan and visit some good consultant
5 years ago
Patient
Post Owner
Are you based in Karachi and treating patients in physical or only available for online consultation? I want to have a consultation booked with my wife tomorrow for a better guidance.
5 years ago
| MBBS | FCPS (Obstetrics & Gynecology)| | Karachi | Book Appointment
right now i can help online but you dr alia bano patel hosp and dr munaza khalid aku main
5 years ago
Patient
Post Owner
My wife now went to Dr anjum ara hasan because agha khan is not available for appointment due to the crisis situation. Dr. believes that the previous case was not really an IUGR but was rather mishandled so said she don't need to go with clexane.
However, I was told that the doctor even tough listened to the case in detail but she had other patients waiting in the line at the same time which is kind of disturbing as this could seriously affect the attention and decision making process.
I am thinking to keep a 2nd dr opinion along the whole pregnancy to keep check of what the doctor is recommending and take guidance to avoid any mishandling this time.
5 years ago