Hello doctor, I am 7 months pregnant and my first pregnancy was a missed abortion. During this pregnancy, I underwent tests like thrombophilia profile and protein S antigen test in which my protein S levels were found low: 58% according to protein S antigen and 32.90% as per protein S functional test. The doctor has told me to take Heparin (Enoxaprin) injection daily of 40 mg throughout my pregnancy and six weeks after delivery. Kindly suggest.
Hi.  Based on your query, my opinion is as follows: 1. Protein S antigen levels are borderline, however the functional activity level is a bit low.  2. This increases the risk of clotting, which is always increased in pregnancy.  3. To reduce anticoagulants like Heparin is necessary. Ecosprin will reduce activity of platelet and hence both will be helpful. Do continue as prescribed. Watch out for any purpura or bleeding spots in skin. You can get a prothrombin and activated partial thromboplastin time done to check the efficacy of heparin, if necessary.