My Wife Is 34 Years And Conceived Through IUI But Termination Twice And Again Naturally Conceived Now Doctor Suggested Lonopin 60 Mg Injection From Week 14 Is It Safe?

Posted on Mon, 16 Jan 2023

Question: My wife is 34 years of age and her weight is 70Kg. She is pregnant for 14 weeks. Doctors has advised her following medicines (prescription attached)-
1. T.uprise D3 1 tab weekly for 4 weeks.
2.T.CoeHbplus 1x1 for 15 days
3. T. Coecoral D3 1x1 for 15 days
4. Morpro DHA powder 2tsp x2 with milk
5. Arzinol XXXXXXX 1/2 glass of water xOD
6.T. Macgest SR 300mg till 26.08.2018
7. T. Ecosprin 75 mg 1x1 for next one month
8.Inj. Lavenone 60mg 1 amp OD or
Cleseane 60mg (Enoxaparin Sodium).
In this regard, I would like to draw your kind attention towards medical history of my wife.
(a) She has conceived through IUI but termination of pregnancy (4+ months) was done due to malformed fetus in November,2016
(b) Again she has conceived through IVF (ICSI) in January, 2018 but again termination of pregnancy was done (by using pills) due to stoppage of heartbeat of fetus at 7 weeks in March,2018.

After that I got a period on 26th April,2018 and and this time she has conceived naturally (spontaneous pregnancy). Now, she is 14 weeks pregnant (ultrasound reports and medical prescription attached).
In this context, (i) I wish to know that doctor has prescribed lonopin 60 mg injection from week 14, considering my history and present status of pregnancy whether she should use lonopin 60 mg injection or not.
(ii) Please also give your valuable advice regarding her pregnancy.

Answered by Dr. Deepti Verma (1 hour later)

Brief Answer:
Limited indications of lonopin

Detailed Answer:
Hi dear,
I have gone through your question and understand the concerns.
I have reviewed the reports and the prescription.
1. Lonopin or low molecular weight heparin is given in pregnancy if the patient has coagulation disorders, Antiphospholipid antibody syndrome, or recurrent pregnancy loss ( more than 2 missed or spontaneous abortions).
In yourwife's situation,in my opinion, there is no recommendation for lonopin.
However, if her APLA, ANA or coagulation profile was found deranged before or during pregnancy , then it is given.
You can upload these reports if available.
2. She should take folic acid, iron, calcium,multivitamins, progesterone as advised by your doctor. High protein diet, timely ANC check ups, ultrasounds, rest is advised.
She should avoid stress and excessive worrying for healthy pregnancy.
Hope you found the answer helpful.
Regards
Dr Deepti Verma
OBGYN
Maternal and fetal medicine specialist

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Deepti Verma (7 hours later)

Thanks Madam for your valuable reply.

In the context of your reply, I wish to know that-
1.What is coagulation disorders, Antiphospholipid antibody syndrome and which test is recommended for this, so that as per your advice necessity of lonopin injection may be decided.

2. What is APLA, ANA or coagulation profile and what test is recommended for this.

3. What is ANC check ups?

Blood and Urine test earlier conducted is attached for needful.

Further, I wish to inform you that our doctor has advice us for NIPT test. Considering our ultrasound report (attached with earlier question), whether we should proceed for this.

Hoping for your valuable reply.

Regards,

Answered by Dr. Deepti Verma (12 hours later)

Brief Answer:
Various coagulation disorders

Detailed Answer:
Hi dear,
1. Coagulation disorders and APLA syndrome are abnormalities in the blood which can lead to recurrent abortion, Intrauterine death' and pregnancy induced hypertension.
Tests like beta2 glycoprotein antibodies, ACL antibodies, LA, Protein C , Protein S levels and APTT are done to recognise these disorders.
However, these tests should be done in interpregnancy period or in early pregnancy less than 6 weeks.The tests are altered in pregnancy beyond 6 weeks and hence no use of getting it done now.
2.I have explained this query in the above point.
3.ANC checkups are regular consultation with your doctor, blood pressure monitoring, and assessment of the growth of the fetus.
NIPT is indicated if the serum screening for chromosomal anomalies is positive, there are soft markers in the genetic sonogram, or there is previous baby with chromosomal anomalies.
There is no indication of NIPT as per your wife's report.
Regards
Dr Deepti Verma

Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Remy Koshy