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Ask Dr. D. Love Your Own Question

Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17557
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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There, My question relates that I was prescribed Clexane

Customer Question

Hi There,
My question relates that I was prescribed Clexane 40 mg/day to be taken from 20 weeks. My BMI is 39 and I'm 35. This is my second pregnancy, so far no complications, I'm 17 weeks at the moment. I had a non-complicated 1st pregnancy with BMI 37 3 years ago, I was not prescribed blood thinners at that time.
I'm quite concerned, as the Consultant did not really explain the reasons why I'm prescribed Claxane besides that women over 100 kgs are prescribed, and that I was younger with my first pregnancy.
I would need to be on Clexane till the end of my pregnancy. Could you please
Submitted: 8 months ago.
Category: Medical
Expert:  Dr. D. Love replied 8 months ago.
Hello from JustAnswer. The reason that the Clexane is prescribed is that women with a BMI >30 is associated with a 2.5-5 times greater risk of developing blood clots, either in the veins, called deep venous thrombophlebitis or DVT, or traveling to the lungs, called pulmonary embolus or PE. And the risk is particularly greater if other risk factors are present. The current guidelines are that prophylaxis against blood clots should be considered in women with multiple risk factors. A BMI > 30 prior to or early in pregnancy is considered a risk factor, and a BMI > 40 is considered a greater risk factor. Age of 35 or older is also considered a risk factor. There may have been other risk factors present that may have been detected on examination. So, the reason that the CLexane is prescribed is to reduce the risk of DVT or PE, because you are at higher risk of developing the complications of pregnancy. If I can provide any additional information, please let me know.
Customer: replied 8 months ago.
Thank you for your quick answer. Could you please let me know what other risk factors could be? As far as I'm aware besides the BMI and the age there are no other risk factors detected in my case.Many Thanks!
Expert:  Dr. D. Love replied 8 months ago.
There are many other possible risk factors, including -1. a history of previous blood clots, either DVT or PE2. any of various conditions that directly affect tendency to form clots, such as antithrombin deficiency or antiphospholipid antibodies, which are frequently associated with lupus3. various medical conditions that indirectly affect the tendency to form clots, such as cancer, systemic inflammatory conditions, heart failure, diabetic nephropathy, or nephrotic syndrome4. IV drug abuse5. a history of three previous deliveries, i.e., not counting current pregnancy6. smoking7. significant varicose veins on exam8. paralysis below the waist There also are certain pregnancy conditions that increase risk for clotting, such as pre-eclampsia, surgery during pregnancy, or any other condition that causes decreased activity

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