TTMA clotting issues; thrombophilia panel??

[thechickencoop]

Ok, so my second hcg isn't back yet (cue rage). I was chatting with the on-call midwife, who, by the way, was incredibly more helpful than the fucking blubbering idiot that I saw at my last check up, and she said that after 3 losses a thrombophilia panel will likely be recommended. Even though I have one bio child it's possible that clotting/blood issues could develop over time? 

Has anyone had this type of testing done? I think it's interesting she would bring it up because with DS I developed pretty severe pregnancy-related thrombocytopenia, which, to a degree is normal but I think my platelets ended up dropping to the mid-40,000 during labor. I had some clotting/autoimmune testing done during my 3rd tri then which came back normal but that was over 3 years ago. 

Am I reaching? I probably am. Ugh.

ETA and I realize they're pretty much opposite issues; I just think it's interesting that some of the testing profiles seem to be the same.

[Deleted]

I've had it done. Mine came back normal. I don't know much about how it develops, but just because you had a successful pregnancy does not mean you don't possibly have issues. I'm glad your mw is being proactive and doing some testing. Have you considered seeing an re for further RPL testing?

[thechickencoop]

Jan 1, 2016 13:57:27 GMT -5 @led said:

I've had it done. Mine came back normal. I don't know much about how it develops, but just because you had a successful pregnancy does not mean you don't possibly have issues. I'm glad your mw is being proactive and doing some testing. Have you considered seeing an re for further RPL testing?

Yea, funny story, we had our initial RE consult scheduled for this past Wednesday, the 30th. I got my + digi on 12/19 but I waited until this Monday, the 28th to cancel the RE appointment. And started bleeding Tuesday. ::punches things::

So now I'm just waiting until next week to call and reschedule. I want to get as much testing done before hand though because from my OB it's all tested through Quest so my insurance covers it. I don't know where the RE runs their testing, whether they do it in house or not and if the lab is covered.

[katelou]

(dirty lurker reply)

I'm so sorry for your losses.

I'm not an expert AT ALL but maybe I can help a little. The two major causes of thrombophilia are congenital and autoimmune. Obvs you can't develop congenital thrombophilia in mid-life, but you can develop autoimmune thrombophilia after previously being healthy. The autoimmune thrombophilias (that I'm aware of, and there is overlap between them) are Lupus Anticoagulant (which you don't have to have lupus to have) and Antiphospholipid Antibody Syndrome. You said you had some autoimmune testing done, normal results unfortunately don't entirely rule out getting an autoimmune disease later on.

Did your platelets bounce back to normal and stay there after pregnancy? There is also an autoimmune version of thrombocytopenia called ITP, which looks similar to gestational thrombocytopenia but will be more severe and persist beyond pregnancy. It is actually not uncommon to have both autoimmune thrombocytopenia and autoimmune thrombophilia (ITP and APS).

I'm not sure if this will be helpful or just freak you out out more. Hopefully helps. Best of luck to you.

[littlelion]

thechickencoop My Ob ordered the testing after 2 losses. I tested positive for MTHFR but have never had any clotting issues. As far as testing goes my bcbs insurance did not pay for it. So that sucked. I'd call your insurance just to be sure. As far as developing it out of nowhere I wouldn't dismiss the possibilty. My younger sister developed the opposite blood clotting condition, she wouldn't clot. Detected in her twenties after she started bruising easily. She had to take medicine and get tested regularly. After awhile she was off the meds and hasn't had any more issues.

GL with moving fwd and hopefully getting some answers/help.

[thechickencoop]

Thank you guys!

katelou, my platelets did return back to normal after delivery; they at least rose out of what they considered a danger-zone (where they were considering transfusion I guess?) within 24 hours because they wouldn't take my epidural catheter out until then (so, ha, yea I remember that milestone!!)

I did see that some insurances don't cover the testing so I will have to call them once I get the lab req. Thanks again!

[thechickencoop]

Jan 2, 2016 11:16:41 GMT -5 Fearsy said:

Jan 2, 2016 7:09:45 GMT -5 thechickencoop said:

Thank you guys!

katelou, my platelets did return back to normal after delivery; they at least rose out of what they considered a danger-zone (where they were considering transfusion I guess?) within 24 hours because they wouldn't take my epidural catheter out until then (so, ha, yea I remember that milestone!!)

I did see that some insurances don't cover the testing so I will have to call them once I get the lab req. Thanks again!

You've gotten some great responses so far. I just wanted to add that I had this testing done by my OB after my second loss. It came back normal and then I found out that insurance didn't cover it. I'm still paying back the bill that was originally $3,650 before I got them to reduce it down to about $2,200. So I encourage you to confirm your coverage with insurance before having it done. ((Hugs))

Oy. Thanks.