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Aim: We prospectively compared the safety of enoxaparin sodium, a low-molecular-weight heparin (LMWH), with unfractionated heparin (UFH), both of which were administered within 24 hours of cesarean section. Methods: A total of 205 pregnant women at increased risk of venous thromboembolism (VTE) who underwent cesarean section for obstetrical indications between December 2012 and February 2015 were eligible to participate in this trial under written informed consent at Hamamatsu University Hospital. They were randomized into two groups based on the subcutaneous injection of enoxaparin sodium or UFH (Enoxaparin [n = 98] and UFH [n = 107] groups, respectively) 6, 18, and 30 hours after cesarean section. Incidences of symptomatic VTE, symptomatic bleeding, thrombocytopenia, and other complications were subsequently compared. Results: One woman in the Enoxaparin group developed symptomatic mild pulmonary embolism (PE). One woman in the UFH group developed a hematoma in the abdominal wound, which required operative evacuation. Conclusion: The safety of thromboprophylaxis with enoxaparin sodium within 24 hours of cesarean section appeared to be similar to that achieved by UFH. A large-scale cohort study is needed to compare the efficiency of inducing thromboprophylaxis by enoxaparin and UFH, in consideration of its rare onset.

Comparison between enoxaparin sodium and unfractionated heparin administered within 24 hours of cesarean section