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Thromboembolic prophylaxis with low molecular weight heparin during pregnancy
Author(s) -
Rasmussen C.,
Wadt J.,
Jacobsen B.
Publication year - 1994
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/0020-7292(94)90351-4
Subject(s) - medicine , pregnancy , low molecular weight heparin , heparin , coagulation , thromboembolic disease , pulmonary embolism , vitamin k antagonist , anticoagulant , postpartum period , obstetrics , thrombosis , anesthesia , gastroenterology , warfarin , atrial fibrillation , genetics , biology
Objective: The objective of this study was to show that low molecular weight heparin (LMWH) can be used in preventing veno‐pulmonary thromboembolic diseases in pregnancy. Methods: Twenty‐four women carrying 27 pregnancies with known risk of veno‐pulmonary thromboembolic diseases in pregnancy were prophylactically treated with LMWH (dalteparin) during part of their pregnancy. Our therapeutic target was a plasma concentration of 0.20–0.50 anti‐Xa U/ml measured 2–6 h after subcutaneous administration of LMWH into the abdominal wall. To obtain this anti‐Xa activity the patients were given total doses of 2500–10 000 anti‐Xa U daily. Monitoring of anti‐Xa activity in patients receiving ≤ 5000 U/day was not necessary. Results: Twelve out of the 24 women received LMWH at the time of delivery. Our biochemical assay could not show the presence of anti‐Xa activity in the blood samples from the babies although it was possible to show anti‐Xa activity in their mothers. In three out of 24 women, blood samples showed activation of coagulation. These patients were changed to the vitamin K antagonist phenindione. Conclusion: None of the treated women showed any clinical or paraclinical signs of thromboembolic diseases during pregnancy or 6 weeks postpartum. All the babies were born healthy. None of the women had any side effects due to the treatment.