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Fragmin p forte during pregnancy after sprain

April 23, 2011 | 10,00 EUR | answered by Dr. med. Ralf Berg

Hello,

a week ago I twisted my foot. Since I couldn't walk anymore, I went to the emergency room at the hospital. Due to my pregnancy (34 weeks), they decided not to do an X-ray. The doctor was of the opinion that if I could still put weight on it, a fracture was unlikely. I was prescribed an Aircast brace and was told that if the symptoms persist, I should come back for a follow-up appointment, where they would also prescribe Fragmin p forte for thrombosis prevention. The symptoms have improved significantly compared to last Saturday. However, the pain is still there, there is a significant hematoma around the entire ankle, and my foot is very swollen due to edema during pregnancy. This is my problem and my question. I followed the doctor's instructions and walked around with my foot as much as possible. Is it still necessary to inject Fragmin p forte after 7 days? If so, where? In the baby bump? Or is Fragmin p forte no longer necessary after a week? What about the swollen foot? Can blood clots be transported away from there at all? Will Fragmin p forte harm my baby? What happens if I am not treated and develop a thrombosis with my baby? I forgot to mention that I have been taking low-dose aspirin (ASS 100) since the 20th week of pregnancy. Is that enough for blood thinning?
I would be very grateful for a prompt response.

Dr. med. Ralf Berg

Good evening, dear expectant mother,

those are a lot of questions at once. 1. If I understand correctly, you have not injected Fragmin P so far and have been walking around eagerly despite your injured ankle? Then a clear answer, in my opinion, doesn't make sense to start Fragmin P now. (No more follow-up questions needed.)
2. Every pregnant woman is already more at risk of thrombosis than non-pregnant women. A prophylaxis with aspirin is already being taken by you for whatever reason. Please continue to refrain from smoking and consume plenty of fluids throughout the day. Then you have (along with exercise) done everything preventatively that you can do, and that should be sufficient.
3. Regarding your swollen leg: Try to accelerate the breakdown of your hematomas by applying HEPARIN Gel (e.g. 60,000 IU is available over the counter). If the ankle is still heavily swollen, try wrapping it with an elastic bandage under the splint. Always elevate the leg when not walking.

I wish you a happy Easter and a successful pregnancy.
Sincerely,
Dr. R. C. Berg