Pillitteri/Kofinas Lovenox Ladies--Come on in!**UPDATE**

I wanted to know if you ladies were told the same thing that I have been told. Mind you, this information did not come from Dr. Pillitteri. It came from Diane at Dr. Kofinas' office (Love her and trust everything she says! lol)

I was there last night for a check-up, I am 32 weeks. I was talking to her about me being a planner and not knowing when this baby will come is really messing with my OCD (we had a good laugh). I was also telling her that we are trying to figure out when MIL should fly here so that she can be here for the birth.

Diane told me that patients like myself who take Lovenox and Baby Asprin are not allowed to go to their due date and that they are induced in their 39th week. She said that they like to have us stop taking the Lovenox and Baby Asprin a few days prior to giving birth. She told me that they used to schedule the induction at 38 weeks but the hospital would rather it be at 39 weeks as long as there are no other impending issues (high blood pressure or heart rate).

So I told Diane that this was wonderful information and I wish someone would have told me this sooner! I am just very surprised that Dr. P never told me this and since I have an appointment with him tomorrow I am going to bring this up.

So my question to you ladies is: Did you know this? If you were told this information when did you find this out and who told you?

**UPDATE**
I had an appointment last night with Dr. P...waited almost 2 hours to see him (grrrr)! I asked him about coming off the BA and Lovenox and being induced at 39 weeks.

He told me that at 36 weeks he is going to have me stop the BA and at around 38 1/2 weeks stop the Lovenox. He said that I will either be induced or scheduled for a C/S in my 39th week. He has a feeling I will have a C/S because of two factors: my LO is breech and she is on track to be close to 9lbs. I am 32w4d right now but measuring at 33w5d and she is weighing in at about 5 lb 11 oz. He told me that Lovenox babies tend to be bigger babies because your blood is thinner to make sure there are no problems with the placenta and that in turn allows more oxygen flow and nutrition flow to your baby.

Message edited 2/4/2011 9:29:03 AM.

Re: Pillitteri/Kofinas Lovenox Ladies--Come on in!

My answer to your question is yes... and no.

I have a who was born via c/sec. I had the option to try a VBAC, but those risks scared me more than recoving from another c/sec... so, I knew I would be a repeat c/sec.

Kofinas' office had orginally told me that they'd probably take the baby early @ 38 weeks and stop lovenox a few days prior.

Pillitteri told me the same thing. As we got closer to Jan. They both said, the hospital won't schedule me before 39 weeks. If I wanted to have the baby @ 38 weeks, I'd have to do an amino to test the lungs. I refuse to do another test on this baby, so, we waited.
Friday the 28th I turned 39 weeks, and that became my schedule date. We stopped taking lovenox that Monday night. I stopped taking the baby asprin a week before that.

I'm not sure about those who will go natrually and I'm unsure about being induced. It seems odd to me that they would induce you? I personally would question that. I think if they just take you off of lovenox early, they're monitoring you weekly at that point anyway. I have to be honest, and please don't take this the wrong way... I wouldn't want to be induced if I was going naturally. It just doesn't make sense to me.

If you have any other questions or anything, feel free to FM.. I feel like I'm rambling now- lol sorry!

Re: Pillitteri/Kofinas Lovenox Ladies--Come on in!

it's also a yes and no for me....i felt the need to plan also so i asked a bunch of questions a while back..i never asked pillitteri about all this only kofinas, i felt asking them was easier b/c i was there weekly.

i found out a long time ago that i wouldn't go full term, b/c of the lovenox and the thromobophilia. I have a scheduled c-section at 39 weeks on 2/18. dr pillitteri took me off the baby aspirin a little over a week ago in case he has to deliver early (it takes longer to get out of your system than the lovenox) i still take the lovenox daily but im assuming i will be off that during the week of my c section.

Message edited 2/2/2011 10:47:35 AM.

Re: Pillitteri/Kofinas Lovenox Ladies--Come on in!

I was given the exact same information by both Dr. Kofinas and Dr. Nguyen at his office. They both said I should have a conversation with my OB and they will support whatever we decide but they DO NOT recommend waiting past the 39th week since the placenta is starting to deteriorate and in my case the baby will get too big to push out (he predicts DS will be around or slightly bigger than 8.5lbs at 39 weeks). You stop with the baby aspirin 5 days prior and Lovenox 2 days prior to the induction. Kofinas even said that if you happen to go on your own and you're in active labor around the time you did an injection they won’t be able to put you on Epidural, which I’m fully intended to take advantage of!!!! I have an appointment with my OB next week and I'm going to bring it up since I'm a huge planner myself and knowing the actual date of birth in advance is like a silver lining for me!!! I hope he’ll be on the same page with Kofinas since a lot of OBs have their own way of doing things… The midwife at the office did tell me they don't like to have these conversations before 36-37 weeks when the baby is considered full term and they start doing internals so we'll see.

Re: Pillitteri/Kofinas Lovenox Ladies--Come on in!

I had never heard of this before and was curious as to why they would induce someone on Lovenox?

I am not a patient of Dr. Pilliterri/Kofinas but I am taking Lovenox and baby aspirin. I had had a miscarriage and 2 chemical pregnancies so I went to Dr. Braverman this summer. He put me on the Lovenox and baby aspirin. Around 9 weeks he discharged me to my OBGYN (Dr. Hanhauer). Dr. Braverman reccomended that I continue the Lovenox and baby aspirin until 36 weeks. Then he said that I should switch to Heprin b/c you can have an epidural, etc. with the heprin but not with the Lovenox. My OBGYN agreed so that is our plan. Lovenox until week 36. I am only 17.5 weeks now so I haven't discussed any of this with my doctor yet but it is interesting that you are all staying with the Lovenox until a few days before the babies' birth.

Re: Pillitteri/Kofinas Lovenox Ladies--Come on in!

The lovenox is designed to only be in your system for 24 hours. I understand why we "go off" the lovenox before delivery. I just don't understand the induction part.

we were going to switch to heprin, but decided to just stay on lovenox.

I also have to remain on lovenox for 6 weeks after delivery. So, I can only say that each case is different in regards to the amount etc...

Re: Pillitteri/Kofinas Lovenox Ladies--Come on in!

i am also not a pillitteri/kofinas girl, but i have heard that people on lovenox get induced. i am on lovenox and baby aspirin and i have absolutely no desire to be induced. i would like to avoid induction and let everything happen as naturally as possible. i will be having this convo with my doctor at some point. he is pretty laid back and thus far im not high risk (even though im on lovenox) so i am hoping that i can just go when is ready!!
i was also a Dr. B girl and had 2 chemicals prior to this pregnancy, and both Dr. B and my OB agreed I should stay on lovenox and BA through the pregnancy. my OB didnt tell me when to stop or switch over but im only 18w so im sure it will come up.

Message edited 2/2/2011 11:48:56 AM.

Re: Pillitteri/Kofinas Lovenox Ladies--Come on in!

Re: Pillitteri/Kofinas Lovenox Ladies--Come on in!

I'm curious... what is Lovenox and why is it given?

I am a Pillitteri/Kofinas girl (well, I have my first appt with Dr. Nguyen on Monday)... but I am only on Baby Aspirin - not Lovenox.

TIA!

Re: Pillitteri/Kofinas Lovenox Ladies--Come on in!

Not a patient there but...

I was on Lovenox and BA. They should not have to induce you at all. I was allowed to go past my Due Date. They just siwtched me at 36 weeks over from lovenox to Heparin.

Re: Pillitteri/Kofinas Lovenox Ladies--Come on in!

I would ask dr p, he deals a lot with it...I know dr P doesnt like for anyone to go past their due date and he usually induces...

Re: Pillitteri/Kofinas Lovenox Ladies--Come on in!

Re: Pillitteri/Kofinas Lovenox Ladies--Come on in!

In regards to switching to Heperin...Diane told me that they don't like to switch lovenox patients to Heperin and I can't remember the exact reason why. She did tell me that if a patients insists on the "wait and see" they will stop the BA and switch to Heperin and you will be monitored very closely and will be going to appointments there twice a week.

I really don't care if I have to be induced because I want whatever is safest for me and the baby.

I plan on talking to Dr. P about this tomorrow night.

I have a feeling my LO is going to be big so I may end up with a C-section anyway.

Re: Pillitteri/Kofinas Lovenox Ladies--Come on in!

Re: Pillitteri/Kofinas Lovenox Ladies--Come on in!

Re: Pillitteri/Kofinas Lovenox Ladies--Come on in!

Posted by Phoebee

Posted by nraboni

In regards to switching to Heperin...Diane told me that they don't like to switch lovenox patients to Heperin and I can't remember the exact reason why. She did tell me that if a patients insists on the "wait and see" they will stop the BA and switch to Heperin and you will be monitored very closely and will be going to appointments there twice a week.

I really don't care if I have to be induced because I want whatever is safest for me and the baby.

I plan on talking to Dr. P about this tomorrow night.

I have a feeling my LO is going to be big so I may end up with a C-section anyway.

Definitely talk to Dr. P about it.
He's the Dr.. Just remember, it's your baby though and your body. That's all I'm saying. Ask about being induced and the success rate. Maybe being induced isn't "good" for your baby? I was induced w/ DD and it put her in disstress that I ended up with a c/sec b/c her heart rate was dropping. I certainly would've loved to avoid an "emergency/ rush" situation. I'm not trying to scare you at all, just giving you some food for thought.

Re: Pillitteri/Kofinas Lovenox Ladies--Come on in!

The recovery is certainly different.

I had a horrible recovery from my It took me a long time to be able to walk and to walk any sort of distance past 2 blocks.

This time with I feel good and I'm not even home a week. I'm still on the drugs, but I'm doing light years better. I had a horrible recovery right afterwards where all I did was vomit all day. Most people are in recovery for an hour, I was in recovery for 4 hours and they finally decided just to move me to the room. The dizziness didn't stop until 8pm that night. I wouldn't say I'm ready to go dancing or anything, just able to walk around a lot better within a better time frame.

I asked Dr. P about it and he said it's b/c the first one, which most Dr.'s do, is cut near the bone. He tends to cut a little higher, but you're not near the main muscles. Also, since I did try to induce, my body went through 5 hours of labor, which I didn't do this time. I'm sure that had something to do with it.

Re: Pillitteri/Kofinas Lovenox Ladies--Come on in!

Posted by Phoebee

The recovery is certainly different.

I had a horrible recovery from my It took me a long time to be able to walk and to walk any sort of distance past 2 blocks.

This time with I feel good and I'm not even home a week. I'm still on the drugs, but I'm doing light years better. I had a horrible recovery right afterwards where all I did was vomit all day. Most people are in recovery for an hour, I was in recovery for 4 hours and they finally decided just to move me to the room. The dizziness didn't stop until 8pm that night. I wouldn't say I'm ready to go dancing or anything, just able to walk around a lot better within a better time frame.

I asked Dr. P about it and he said it's b/c the first one, which most Dr.'s do, is cut near the bone. He tends to cut a little higher, but you're not near the main muscles. Also, since I did try to induce, my body went through 5 hours of labor, which I didn't do this time. I'm sure that had something to do with it.

Re: Pillitteri/Kofinas Lovenox Ladies--Come on in!

those are not my physicians BUT, here is what I was told

I went off lovenox at 36 weeks and on heparin 2x daily. the plan was to keep using the heparin until I went into labor (12 hour life so it really should be out of your system 12 hours after last dose, usually enough time before delivery)...

I was told that I COULD go to my EDD and even a few days after. They would NOT however, induce if I had zero progress. My OB feared stressing my uterus with a long labor that would end in csection and then possible bleeding issues.

It didnt matter for me. We elected a csection at 40w2d because I had zero progress and DS was still floating high since I had a TON of fluid. My OB would have let me go 3 more days and if I still had zero progress, it was csection also so I just went with it at 40w2d.

i dont know if that is helpful but i thought a different OB's perspective might help!

ETA - i went back on Lovenox 12 hours after csection and stayed on it for 6 weeks!

I was on Lovenox for thrombophelia, MTHFR and a few other things.

Message edited 2/2/2011 2:02:11 PM.

Re: Pillitteri/Kofinas Lovenox Ladies--Come on in!**UPDATE**

bump for update after appointment

Re: Pillitteri/Kofinas Lovenox Ladies--Come on in!**UPDATE**

Re: Pillitteri/Kofinas Lovenox Ladies--Come on in!**UPDATE**

Posted by maymama

Posted by nraboni

bump for update after appointment

interesting, ive never heard that about lovenox babies being bigger maybe thats why DS was 8.7!

Re: Pillitteri/Kofinas Lovenox Ladies--Come on in!**UPDATE**

Thank you for posting the update I was very curious what your DR will say. I'm glad he and Dr. Kofinas are on the same page since a lot of Drs have disagreements over courses of treatment. I have an appointment on Tuesday and will update on what my OB suggests. At my last Kofinas appt which was this Tuesday (33w3d) baby was measuring 5lbs8oz and dr said there's no way I'll be able to deliver naturally if I go past 39 weeks since he'll be too big! So I guess all those extra placenta juices are doing their job right

Re: Pillitteri/Kofinas Lovenox Ladies--Come on in!**UPDATE**

I'm crashing with a quick question. I had an unexplained miscarriage (the results came back that the chromosomes were normal) and I was sent to a perinatal doctor by my OB. The perinatal doctor is sending me for blood tests. One is an antibody test (he said it has to do with blood clotting) and the other is a progesterone test. I am having the testing done this month before we TTC again next month.

I know if I test positive for any of the anitbody issues I will be prescribed either lovenox/heparin/aspirin. Here is my question: why are you taking these medications? Were you tested before you were pregnant for an antibody issue? Or did you doctor discover an issue with your pregnancy?

I'm just wondering how common it is to test positive for an antibody/clotting issue? Is it a common thing?

Re: Pillitteri/Kofinas Lovenox Ladies--Come on in!**UPDATE**

Posted by Phoebee

Posted by maymama

Posted by nraboni

bump for update after appointment

interesting, ive never heard that about lovenox babies being bigger maybe thats why DS was 8.7!

I was told that by several Dr.'s and several Mom's who were on Lovenox.

Although, they were estimating DS to be aprox 8.5lbs and he was born @ 7.3lbs. OK, a big jump from DD who was only a mere 5.4lbs when she was born.....