Pai-1 4G/5G mutation

[sunshine10]

My tests came back homozygous for Pai-1 4G/5G mutation. Anybody know anything about this? The doc said not to worry about it and asprin should be sufficient, but didn't say anything more about it.

[dawn]

I don't know what that is. I am heterozygous (1 gene mutation) for a blood clotting condition MTHFR and it required me to not only be on aspirin, but heparin injections, extra folic acid and prednisone, in order to carry my last two.

[sunshine10]

I am also heterozygous for the MTFR gene as well. The doc said I would not need anticoagulants. I have read this is a common controversy among docs. I hope this does not work against me.

[Debs]

I do not have this mutation, but once you have known me for long you will find that if you give me a medical puzzle, i'll research it to death.

This particular mutation puts you at higher risk for thrombosis (blood clots). In particular, it puts you at higher risk for "microclots" early in pregnancy, where you miscarry the baby very early on because the tiny vessels forming in the trophoblast get clotted off before the placenta has much of a chance to develop. This matches pretty strongly with your m/c history. In your shoes, I would be pushing for a low dose of heparin/lovenox as well. Of course you have to go with what you are comfortable with (and I am not a doctor), but looking at the research and your history, I would push a bit for further treatment.

Incidentally, if you ever go in for surgery etc. in the future, the surgeon should be aware of this diagnosis. This particular mutation puts you at greater risk for thrombosis after surgery, as well. I would probably consult with a hematologist to be sure there is not more you need to do (such as low dose aspirin outside of pregnancy).

Given your early m/c history, I would be sure you are taking a low dose aspirin daily throughout your cycle so that when implantation occurs you already have some protection from clotting. I agree that this is a point of controversy among doctors, but with your m/c history, I would lean toward pushing for a more aggressive approach.

[sunshine10]

Debs,

Thanks so much for doing the research. You answered a lot of my questions. Most of the info about it is in research papers which I don't have the patience to sift through. I will look more into this with my doc. I have a tendency to bruise easily so I wonder if this mutation has anything to do with it.....