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Warfarin after childbirth?
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Any idea why a young girl would be commenced on warfarin after childbirth
Im aware of what warfarin is for etc but im not familiar with this scenario x
Im aware of what warfarin is for etc but im not familiar with this scenario x
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my daughter gave birth in july and as she has a 'high BMI' she had to give herself warfarin injections daily for 2 weeks and she was also supposed to wear support stockings. we all thought this was rather harse (the injections) as she is no different now to when she had her previous baby and has always been very healthy with no medical problems and sailed through her pregnancy again with no problems. I would just add she had to be under some additional special consultant throughout pregnancy due to BMI which was a complete waste of time and money.
Ermm - seems all a little strange, tbh. Was she on warfarin prior to the pregnancy or during the pregnancy? There are conditions ,such as pregnancy induced hypercoagulability, the clinical significance of which could be a DVT or similar pulmonary embolism, but mostly they would tend to use Low Molecular Weight Heparin. Warfarin could theoretically have a teratogenic effect prior to 6 weeks gestation ( although it seems to be ok after that)
Therefore, only if she is at high risk for hypercoaguability would they be using prophylactic anticoagulation, ( hereditary coagulation factor disorder, previous history of DVT, AntiThrombin III deficiency), and this usually starts 3-6 months prior to birth , and will continue after birth for around 3 months or so.
I dont think her having sepsis would be a reason to treat with coagulant therapy.Sepsis can, in some circumstances, cause a derangement of the coagulation pathway ( interference due to byproducts of the inflammatory process which can also be involved with the coagulation pathway).There have been some studies of the use of anticoagulant therapies in sepsis, but a recent meta-review of the 11 best trials, totalling around 5000 patients, concluded that they do not improve sepsis significantly, especially when compared to the risk of bleeding,
@ Im a busybee - That I am aware of, Warfarin is only available as an oral therapy, in tablet form, so your daughter could not have been self-injecting with warfarin. Given that a high BMI could, in pregnancy, be a significant risk factor for DVT or PE, then the precautionary principle and ethics of medicine say that your daughter should be treated prophylatically in exactly the manner she was - Absolutely not a "waste of time and money" .
I think she would have been self- injecting Low Molecular Weight Heparin, rather than warfarin.
Therefore, only if she is at high risk for hypercoaguability would they be using prophylactic anticoagulation, ( hereditary coagulation factor disorder, previous history of DVT, AntiThrombin III deficiency), and this usually starts 3-6 months prior to birth , and will continue after birth for around 3 months or so.
I dont think her having sepsis would be a reason to treat with coagulant therapy.Sepsis can, in some circumstances, cause a derangement of the coagulation pathway ( interference due to byproducts of the inflammatory process which can also be involved with the coagulation pathway).There have been some studies of the use of anticoagulant therapies in sepsis, but a recent meta-review of the 11 best trials, totalling around 5000 patients, concluded that they do not improve sepsis significantly, especially when compared to the risk of bleeding,
@ Im a busybee - That I am aware of, Warfarin is only available as an oral therapy, in tablet form, so your daughter could not have been self-injecting with warfarin. Given that a high BMI could, in pregnancy, be a significant risk factor for DVT or PE, then the precautionary principle and ethics of medicine say that your daughter should be treated prophylatically in exactly the manner she was - Absolutely not a "waste of time and money" .
I think she would have been self- injecting Low Molecular Weight Heparin, rather than warfarin.
@ Sqad - sure, but not if there were major complications/ traumatic events in the process of childbirth itself - Hypercoagulability would not stop haemorrhage due to rupture or tears, or something like uterine atony, which is responsible for what, around 70% of PPH? for example.
Insufficient info from the OP to offer a proper informed opinion :)
Insufficient info from the OP to offer a proper informed opinion :)
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