Q: What is Factor V Leiden?
Factor V Leiden (FVL) is a genetic mutation that makes you more prone to have blood clots. It is not all that uncommon in caucasians (between 5-15% of the population may have it) but it does not generally cause problems so most people who have it are unaware. It's usually discovered if a person or a close family member has deep vein thrombosis (DVT) or late or recurrent pregnancy loss.
Q: What health implications are there for those with FVL?
You should reduce your risk of forming clots by working on the risk factors that can be changed. You should not smoke, should exercise regularly & watch your weight. You should never take hormone supplements (birth control or hormone replacement therapies) that contain estrogen. If you are traveling or otherwise sitting for long periods of time, you should periodically take breaks to move around as much as possible. You should notify your doctor if you ever have surgery so you can be treated prophylactically with blood thinners. It is important to always stay well hydrated.
Q: Does FVL only affect women?
No, men are just as likely as women to have the mutation. However, many women are diagnosed in connection with a pregnancy because pregnancy is a hypercoagulative state. The body forms clots more easily when pregnant as a natural protection against hemorrhage.
Q: What is the treatment for FVL in pregnancy?
Many women with FVL have healthy pregnancies without treatment (I had 3 full-term babies before I had multiple miscarriages & testing). However, for those with a history of clots or pregnancy loss, most doctors recommend low-dose aspirin therapy and/or daily injections of heparin or lovenox. For patients without a history of clots or pregnancy loss who test positive for the mutation after a family member is diagnosed may be advised to take low dose aspirin, but opinions vary.
Q: I've heard pregnant women aren't supposed to take aspirin?
Generally they are not. Aspirin is a blood thinner and can cause bleeding problems. But, for pregnant women with FVL who clot too much, blood thinners help return the body to a state of equilibrium. Women should not take aspirin to prevent miscarriage unless their doctor has diagnosed or strongly suspects (due to late or recurrent pregnancy loss) that there is a clotting issue.
Q: How is FVL diagnosed?
Specific blood tests can reveal this mutation. FVL is also known as "Activated Protein C resistance". You doctor may simply order the APC resistance test or may order DNA analysis. The DNA test is slightly more accurate (about 2% of APC resistance is not caused by genes) but takes slightly longer to receive results (usually 7-10 day wait).
Wednesday, June 22, 2011
Monday, June 20, 2011
Mother of Hope
We had our 1st baby while my husband & I were in law school. I think most of our classmates thought we were irresponsible or crazy (or both!) to have a child while still impoverished students. We had been married 3 years. We were thrilled to welcome a healthy little boy! And he WAS little...5lb.7oz. He got a special mention at my graduation the next spring. Three years later, we had a little girl. We loved being parents.
After 2 healthy pregnancies & uncomplicated deliveries, we felt confident enough to see a CPM (homebirth midwife) for our 3rd pregnancy. Unfortunately, I started bleeding when I was 9 or 10 weeks. (I have irregular cycles, so due date isn't usually established until the baby is measured in the 1st ultrasound.) I went in for an ultrasound which revealed that the baby had stopped growing a few weeks earlier. But, miscarriages are common and although we grieved the loss, we didn't think that anything was amiss. My body had already proven it could carry healthy babies to term. And about a year later, it proved it for the 3rd time. We loved our homebirth experience & loved that our little family was growing.
Last year, we suffered our 2nd miscarriage. That was much tougher than the 1st loss. At a routine appointment in the 2nd trimester, we discovered that the heart was no longer beating. We chose to wait for my body release the pregnancy naturally. Five days after the appointment, I started bleeding. My water broke & I hurried to the bathroom & caught the baby. We named him James because we liked the lullaby "Sweet Baby James". We had him creamated. We followed up with an OB, but no testing for causes was recommended & we didn't push for any.
About a year after we delivered James, we decided to try again & hope for the best. Things seemed fine. I had a little spotting and went in for an ultrasound. We saw a heartbeat inside our wiggly baby & felt reassured. But, a couple weeks later I started bleeding again- heavier this time. The midwife listened with a doppler & found a nice strong 170 heartbeat. Early the next morning my water broke. The placenta came out before the baby, so we think there was placental abruption. I was 14 weeks. She measured 5inches long. We named her Hope. Our OB did a lot of testing after that. They found a 7cm fibroid near my fundus & lots of ovarian cysts. But, the OB & the Perinatologist are confident that the Factor V Leiden which they found I am heterogyous for is the primary reason I've had late miscarriages.
We'd like to have another baby, but with our history, we are pretty anxious about it. I wanted to start this blog to share my story, learn about other women's experiences, & to develop a resource for those looking for answers about FVL & pregnancy. My main objective is to lend support and offer information to others, so please share your story in the comments.
After 2 healthy pregnancies & uncomplicated deliveries, we felt confident enough to see a CPM (homebirth midwife) for our 3rd pregnancy. Unfortunately, I started bleeding when I was 9 or 10 weeks. (I have irregular cycles, so due date isn't usually established until the baby is measured in the 1st ultrasound.) I went in for an ultrasound which revealed that the baby had stopped growing a few weeks earlier. But, miscarriages are common and although we grieved the loss, we didn't think that anything was amiss. My body had already proven it could carry healthy babies to term. And about a year later, it proved it for the 3rd time. We loved our homebirth experience & loved that our little family was growing.
Last year, we suffered our 2nd miscarriage. That was much tougher than the 1st loss. At a routine appointment in the 2nd trimester, we discovered that the heart was no longer beating. We chose to wait for my body release the pregnancy naturally. Five days after the appointment, I started bleeding. My water broke & I hurried to the bathroom & caught the baby. We named him James because we liked the lullaby "Sweet Baby James". We had him creamated. We followed up with an OB, but no testing for causes was recommended & we didn't push for any.
About a year after we delivered James, we decided to try again & hope for the best. Things seemed fine. I had a little spotting and went in for an ultrasound. We saw a heartbeat inside our wiggly baby & felt reassured. But, a couple weeks later I started bleeding again- heavier this time. The midwife listened with a doppler & found a nice strong 170 heartbeat. Early the next morning my water broke. The placenta came out before the baby, so we think there was placental abruption. I was 14 weeks. She measured 5inches long. We named her Hope. Our OB did a lot of testing after that. They found a 7cm fibroid near my fundus & lots of ovarian cysts. But, the OB & the Perinatologist are confident that the Factor V Leiden which they found I am heterogyous for is the primary reason I've had late miscarriages.
We'd like to have another baby, but with our history, we are pretty anxious about it. I wanted to start this blog to share my story, learn about other women's experiences, & to develop a resource for those looking for answers about FVL & pregnancy. My main objective is to lend support and offer information to others, so please share your story in the comments.
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