Pregnant while on Marcoumar therapy
February 23, 2010 | 10,00 EUR | answered by Dr. med. Olaf Stephan
Good evening,
I have an important question.
I have been taking Marcoumar for half a year because I had a deep vein thrombosis in my left lower leg and behind the knee.
Yesterday I found out that I am pregnant, I should still be very early in the pregnancy, meaning the doctor has not seen a fertilized egg yet but she saw the gestational sac and said that by Monday more should be visible. Because I did not expect to be pregnant at all, I was a bit overwhelmed at first and told her that I do not want to have a child right now, especially since I do not know how it will be with the Marcoumar therapy. She told me to think about it until Monday and then she will first check if there really is an egg implanting. Because it is also possible that no egg implants due to the Marcoumar.
As a result, I went to my treating doctor (phlebology) today and discussed my situation with him. He told me that we will slowly stop the Marcoumar until next week, as the therapy would have ended in 4 weeks anyway, but he strongly advised me against keeping the child, he said that the child will have disabilities 99% of the time and I absolutely do not want that, thankfully I have a healthy daughter but I definitely do not want a disabled child.
I just don't understand why my gynecologist didn't tell me that. Because if she had told me that, I could have told her right away that I want to have an abortion and now I have to wait a week to see what happens with the egg and then I will probably find out it has implanted but could be disabled.
I really don't know what to believe anymore!!
If I have an abortion, is it possible to do it with the abortion pill? I am so afraid of general anesthesia, and I don't know if the abortion will be easy since I still have to take Marcoumar until Saturday and then it will be finally stopped.
Please help me understand a little more??
Thank you very much!
Greetings Janine
Dear inquirer,
First of all, a few words about therapy with Marcumar. This is a so-called anti-vitamin K, meaning the medication reduces the physiological, vitamin K-dependent formation of certain factors in blood coagulation, thereby reducing the blood's clotting ability overall, depending on the dosage administered. It was used in your case to prevent a recurrence of thrombosis. If you have been undergoing the therapy for half a year already, that is a sufficient period of time, assuming that the lower leg thrombosis is the first event of this kind. Therefore, you can now stop the Marcumar therapy altogether, meaning you simply don't need to take the tablets anymore and your blood clotting will return to normal within a few days. During this time, you will surely find out if you are pregnant or not. The medication Marcumar is absolutely prohibited during pregnancy, as it is very likely to cause serious fetal damage, especially when used in early pregnancy. Therefore, termination of pregnancy is certainly indicated, especially since you currently do not wish to have a child. It is always important in the context of therapy with Marcumar in younger women to ensure effective contraception if there is a desire to have children, and if anticoagulant therapy is medically necessary at the same time, after switching to heparin injections, a completely normal pregnancy is possible, but this should be done before pregnancy for the reasons mentioned above.
If the clotting activity of your blood has returned to normal in the next few days after stopping Marcumar, termination of pregnancy is also possible without any issues. If you wish, it can also be done with the medication RU 486, which has been allowed in Germany since 2008 up to the ninth week of pregnancy (apparently you are in a very early stage of pregnancy anyway). Your treating gynecologist can provide detailed advice on this, as there is a justified medical indication for termination of pregnancy. The medication usually leads to heavier bleeding shortly after intake, so a normal clotting ability of the blood is necessary for this. I hope that my brief explanation could help you understand the issue.
Best regards, O. Stephan
