Maternity
Introduction
This leaflet is for women who have recently given birth and who need to have heparin injections at home. It gives information about heparin, why you need it and the instructions for taking it.
Why do I need heparin injections?
Pregnancy and childbirth can increase your risk of developing a blood clot (venous thromboembolism)
What is a venous thromboembolism (VTE)?
Blood clots or venous thromboembolism (VTE) is a term for both deep vein thrombosis (DVT) and pulmonary embolism (PE)
Deep vein thrombosis (DVT)
A DVT is a blood clot in the deep veins. This is most commonly in the lower limbs but can occur in any deep vein.
DVTs may scar veins which may lead to a condition called post thrombotic syndrome later in life, this can result in chronic pain, swelling of the leg and in severe cases leg ulcers
Pulmonary embolism (PE)
A PE is when all or part of the DVT breaks off, travels through the body, and blocks the blood vessels to the lungs this is potentially life threatening. You can have a PE without experiencing signs and symptoms of a DVT.
After giving birth, we will have assessed your risk of developing a blood clot. This risk assessment has indicated that you are at a higher risk of developing blood clots. This risk can be greatly reduced by having a course of heparin injections. Occasionally you may also be given anti-embolism stockings to wear.
How does heparin work?
During pregnancy and for about six weeks after you give birth, your blood becomes stickier. This is to reduce the risk of heavy bleeding during pregnancy and after delivery. The blood flow therefore slows down in the veins in your legs and pelvis.
Heparin is an anticoagulant which increases the time your blood takes to clot. This reduces the risk of developing or extending a blood clot in the body.
How is heparin given?
Heparin must be prescribed for you, and it is always given by injection. The syringes come ready-prepared with the correct dose.
Your midwife will show you how to give yourself heparin injections. Most women manage this very easily. If you need additional help, please ask your midwife.
The needle on the syringe is very fine and although the injection may sting slightly, it is not too painful.
The midwife will also give you a sharps bin to dispose of the used needles safely. You can return your used sharps bin to the ward that gave it to you.
Heparin is safe to use if you are breastfeeding.
Instructions for giving yourself a heparin injection
To help avoid any sore, red, or bruised areas on the skin where you are injecting, try to change the sites you use for the injections. If you get a skin rash at the site of the injection, please let your midwife know.
It is important to keep the stock of injections and the sharps box in a safe place, out of the reach of children.
What are the risks of heparin?
There are minor side effects from heparin. You may find you have stinging which will wear off after a short time and bruising around the injection site. Small lumps may form under the skin these are nothing to worry about and will resolve, try to avoid injecting to these areas.
Occasionally like any other medication you may develop an allergic reaction to heparin if this occurs you may find reddening, itching and urticarial rash (nettle rash) at injection sites. If this does occur please contact midwife/maternity triage straightaway so your treatment can be reviewed Do not stop your injections without seeking advice.
What happens when I go home?
To reduce the chance of developing a blood clot, it is essential that you complete the full course of injections.
Please make sure that the sharps box you have been given for the disposal of your syringes is returned to your midwife or the Maternity Unit. Never throw it out with your household rubbish.
If you need anti-embolism stockings, you should remove them every day so you can wash your legs and check your skin for any changes. Please refer to the manufacturer’s instructions for washing the stockings and for other handling advice.
Tell your doctor or midwife if you experience any of the following on your feet or legs:
What else can I do to help prevent blood clots?
What are the signs and symptoms of blood clots?
Please be aware that it is possible to experience symptoms of PE without having symptoms of a DVT
If you think you may have VTE, you should seek medical advice immediately and attend your nearest A&E (Emergency Department).
If you have any questions, or if there is anything you do not understand about this leaflet, please contact:
Maternity triage on 01384 456111 ext. 3053
This leaflet can be downloaded or printed from:
http://dgft.nhs.uk/services-and-wards/maternity/
Can I find out more?
You can find out more from the following web link:
Reducing the risk of venous thrombosis in pregnancy and after birth | RCOG
If you have any questions, or if there is anything you do not understand, please contact the Russells Hall Hospital switchboard number on (01384) 456111 and ask for the relevant department who issued this leaflet.
This leaflet can be made available in large print, audio version and in other languages, please call 0800 073 0510.