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BJOG. 2002 Sep;109(9):1020-4.

Low molecular weight heparin for the treatment of venous thromboembolism in pregnancy: a case series.

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

Abstract

OBJECTIVES:

To assess the use of low molecular weight heparin for the treatment of venous thromboembolism in pregnancy.

DESIGN:

A prospective observational study.

SETTING:

The maternity units in two university teaching hospitals and one district general teaching hospital.

POPULATION:

Thirty-six consecutive women presenting with objectively diagnosed venous thromboembolism during pregnancy and the immediate puerperium.

METHODS:

Treatment with the low molecular weight heparin enoxaparin, approximately 1 mg/kg s.c., twice daily, based on early pregnancy weight.

MAIN OUTCOME MEASURES:

Peak anti-Xa activity (three hours post-injection), alterations in treatment, side effects and the use of regional anaesthesia.

RESULTS:

In 33 women, the initial dose of enoxaparin provided satisfactory peak anti-Xa activity (median 0.8 u/mL, range 0.44-1.0 u/mL) and was continued. Three women required dose reduction since peak anti-Xa activities were above the therapeutic range (1.2, 1.2 and 1.1 u/mL). No woman developed thrombocytopaenia, haemorrhagic complication or further thromboembolic episode. Two women developed allergic skin reactions on enoxaparin and were changed to tinzaparin. Fifteen women had regional anaesthesia for delivery, with a reduced dose of enoxaparin (40 mg once daily), all without complication.

CONCLUSIONS:

Enoxaparin is a safe and effective treatment for venous thromboembolism during pregnancy and confers a major advantage over unfractionated heparin through its simplified regimen of administration.

PMID:
12269676
[Indexed for MEDLINE]
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