I had pulmonary embolism in my teen age. Will it affect my future pregnancy?

Question

Hi doctor,

When I was 15 years old, I had a bilateral pulmonary embolism with no known causation. I was wondering about my options for pregnancy in the future, rather, if it would be an option. I am currently taking Apixaban twice daily, and I am unsure of when I will stop taking it. My clots have now dissolved, and I am doing alright. This may be a difficult question to answer, but I am curious nonetheless.

Answer 1

Hi,

Welcome to icliniq.com.

Happy to hear that you are doing well and it is very wise to be concerned about your future pregnancy. So let me outline a few things for you. Pregnancy itself is a state in which blood clots more than in a non-pregnant person. This is due to an increase in progesterone and estrogen during pregnancy. Since you are high risk for clotting disorders (due to your history of pulmonary embolism (PE)) your chances of clots forming in your legs (DVT) and lung again (PE ) during pregnancy is increased by many folds. This puts you in high risk pregnancy category, which means even if you can get pregnant, it has to be planned and monitored very closely. During pregnancy, you will be started on low molecular weight heparin to prevent clotting and blood parameters like bleeding and clotting time, INR will be monitored. Let all this not worry you. Apixaban is toxic to pregnancy, hence contraception and prevention of pregnancy until the time you are on this drug is advised. So when you plan to get pregnant, prenatal counseling by a gynecologist and this drug switched to a safer pregnancy alternative. All this said and done, if you take the appropriate care and medication you can have a safe and uneventful pregnancy.

I hope this helps.