Document Detail


Antenatal use of enoxaparin for prevention and treatment of thromboembolism in pregnancy.
MedLine Citation:
PMID:  11002955     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
J Ellison; I D Walker; I A Greer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  107     ISSN:  1470-0328     ISO Abbreviation:  BJOG     Publication Date:  2000 Sep 
Date Detail:
Created Date:  2000-10-12     Completed Date:  2000-10-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1116-21     Citation Subset:  AIM; IM    
Affiliation:
University Department of Obstetrics and Gynaecology, Glasgow Royal Maternity Hospital and Glasgow Royal Infirmary, UK.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anticoagulants / therapeutic use*
Enoxaparin / therapeutic use*
Factor Xa / metabolism
Female
Gestational Age
Humans
Pregnancy
Pregnancy Complications, Cardiovascular / drug therapy*,  prevention & control
Prenatal Care / methods
Retrospective Studies
Thromboembolism / drug therapy*,  prevention & control
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Enoxaparin; EC 3.4.21.6/Factor Xa

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