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BJOG. 2000 Sep;107(9):1116-21.

Antenatal use of enoxaparin for prevention and treatment of thromboembolism in pregnancy.

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  • 1University Department of Obstetrics and Gynaecology, Glasgow Royal Maternity Hospital and Glasgow Royal Infirmary, UK.

Abstract

OBJECTIVE:

To assess the safety and efficacy of enoxaparin use for thromboprophylaxis or treatment of venous thromboembolism during pregnancy.

DESIGN:

Retrospective review of casenotes of women who received enoxaparin during pregnancy.

SETTING:

Obstetric Medicine Unit at Glasgow Royal Maternity Hospital.

SAMPLE:

Data were obtained on 57 pregnancies in 50 women over six years.

METHODS:

Information was obtained from case records in relation to outcome measures, the presence of underlying thrombophilia and indication for anticoagulation.

MAIN OUTCOME MEASURES:

Incidences of venous thromboembolism, haemorrhage, thrombocytopenia, peak plasma anti-factor Xa levels and symptomatic osteoporosis.

RESULTS:

There were no thromboembolic events in the thromboprophylaxis group. There were no incidences of heparin-induced thrombocytopenia. Twenty-two women had spinal or epidural anaesthesia and no complications were encountered. There was one instance of antepartum haemorrhage following attempted amniotomy in a woman with previously unknown vasa praevia. Two women sustained postpartum haemorrhage, both secondary to vaginal lacerations, resulting in blood loss > 1,000 mL. Blood loss following caesarean section was not excessive. No instances of vertebral or hip fracture were encountered. The median peak plasma anti-factor Xa level on a dose of 40 mg once daily was 0.235 U/mL; peak plasma anti-factor Xa levels were not affected by gestational age.

CONCLUSIONS:

The use of enoxaparin in pregnancy is associated with a low incidence of complications and a dose of 40 mg once daily throughout pregnancy provides satisfactory anti-factor Xa levels and appears effective in preventing venous thromboembolism.

PMID:
11002955
[PubMed - indexed for MEDLINE]
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