It goes without saying that no other period in a woman’s life is more transformative than pregnancy. Expectant moms witness a series of changes during each trimester while facing various physical and emotional challenges. They could experience a number of issues that may range from common discomforts like morning sickness to more serious complications that require extreme levels of vigilance. One such health issue that requires serious consideration is coagulation disorders. The presence of such disorders poses a significant health risk even when one is not pregnant. So, it becomes vital to understand, monitor and manage such disorders when they are diagnosed in pregnant women.
In this article, we’ll take a quick look at coagulation disorders and the role of medications like heparin and aspirin in managing such disorders during the pregnancy period.
Coagulation, commonly known as blood clotting, is a vital part of the body’s healing process. It helps prevent excessive bleeding from damaged blood vessels. When an injury occurs and the blood vessel begins to bleed, a type of protein (coagulation factors) will work with tiny blood cells called platelets to form a sort of protective layer or patch (clot) over the wound, thus plugging the blood flow. In the next stage, the blood vessel shrinks a bit to restrict the blood flow, and another type of protein called fibrin creates a more sturdy barrier that completely stops blood loss. However, due to genetic predispositions, this process may become hindered when there are abnormal levels of the coagulation factors or platelets, thus giving rise to coagulation disorders.
Coagulation disorders occur when there is a failure to control the formation of blood clots. In other words, the body may form either too many or too few blood clots. This could lead to potentially dangerous health issues. A person may suffer from excessive bleeding if the blood clotting process fails to occur or, alternately, suffer from blocked blood vessels if too many blood clots are formed.
Coagulation disorders are problematic and could prove to be fatal if not managed properly. Pregnant women, in particular, need to be given special care as they are in a highly vulnerable state. During pregnancy, there is higher blood volume and pressure, making it more likely to develop blood clots, even if they have never had a coagulation disorder before. However, it must be noted that despite being diagnosed with blood clotting disorders, most women have healthy and successful pregnancies.
If the expectant mother has been diagnosed with this disorder or has a family history of clotting disorders, they must be closely monitored throughout the pregnancy period, and their health issues must be managed as carefully as possible. Failure to do so could lead to a number of problems for both the expectant mom as well as her unborn child. A blood clotting disorder, such as antiphospholipid syndrome, could cause miscarriages and other pregnancy complications. Venous thromboembolism and thrombophilia are other blood clotting disorders that could occur during pregnancy.
If coagulation disorders have been diagnosed during pregnancy, or if the expectant mother was already suffering from such disorders before becoming pregnant, it becomes imperative to start treatment for the same. Here’s a quick look at the anticoagulant therapy for pregnant women who may be at risk from coagulation disorders.
Anticoagulants are medications prescribed to prevent or manage blood clotting disorders. They can break down existing blood clots and restrict the formation of new ones. Anticoagulants can be administered orally, intravenously, or as injections.
Pregnant women may be prescribed anticoagulants when:
● They have been diagnosed with coagulant disorders or abnormal blood clotting, either before or during their pregnancy.
● When common pregnancy-related health issues like dehydration cause the blood to thicken, thus prompting the need for blood thinners.
● There is a chance of developing blood clots, perhaps due to a family history of blood clotting disorders.
● They have been diagnosed with abnormal heart conditions and require blood thinning to prevent the formation of blood clots during pregnancy.
Let’s take a look at heparin use in pregnancy. Heparin is one of the most effective anticoagulants (blood thinners) that can be administered to pregnant women. It is also one of the safest anticoagulants, as it does not go through the placenta and into the fetus’s circulation, thus posing no risk to the baby growing within the womb.
Heparin cannot be taken as a pill since the digestive system cannot absorb it. This is why heparin treatment is done either by injecting the required dosage subcutaneously (under the skin), or intravenously, in the form of heparin infusions through IV lines. This treatment is continued for three to six months so as to prevent new or larger blood clots from forming. A lower dose of heparin will be administered after the birth of the baby for approximately six weeks or so, as the risk of developing blood clots still remains high.
Aspirin is a commonly available medication used to reduce inflammation, pain and fever. Aspirin is also one of the most commonly prescribed antiplatelet drugs, typically taken by people who have had a heart attack or stroke. Antiplatelet drugs help restrict platelets from sticking together, which in turn decreases the body’s ability to create blood clots.
Thus, due to its anti-platelet effect, undergoing aspirin therapy during pregnancy is yet another way to manage blood clotting disorders. Low-dose aspirin is a safe way to circumvent any risks that may arise from blood clotting conditions. It can be prescribed in low dosages (usually around 81 milligrams) during pregnancy if coagulation disorders are diagnosed.
Heparin and low-dose aspirin benefits in pregnancy have been the subject of several studies. Heparin-based and aspirin-based treatments are both used for managing coagulation disorders during pregnancy. These treatments may be used, either independently or in combination with each other, to treat coagulation disorders. The main difference between the two is that while heparin is an anticoagulant that makes coagulation or clotting factors inactive, aspirin is an antiplatelet that prevents platelets from clumping together.
A healthcare professional will assess the health issues and overall physical condition of the expectant mother before prescribing the treatment for managing coagulation disorders.
Managing a blood clotting disorder during pregnancy can feel overwhelming, with expectant moms becoming fearful for their health as well as the health of the child growing within their womb. However, having an in-depth understanding of this medical condition and working closely with their healthcare providers can empower them to navigate their pregnancy journey with confidence. Remember, with the right care and support, many pregnant women with blood clotting disorders go on to have successful pregnancies and healthy babies.
So, make sure to be alert and proactive, and have regular consultations with your doctor if you have been diagnosed with or are at risk from coagulation disorders.
Heparin is a potent anticoagulant. It renders inactive the proteins or coagulation factors needed for the blood clotting process to occur. This consequently prevents blood clots from being formed when a blood vessel is injured.
Yes, both heparin and aspirin are safe for the baby during pregnancy. Heparin cannot cross the placenta and enter the baby’s blood circulation. Pregnant women are usually prescribed low-dose aspirin, which is generally safe for both mother and child.
Yes, both heparin and aspirin can reduce recurrent miscarriages caused by blood clotting disorders when used in the prescribed dosages and under the supervision of a qualified healthcare professional.
