Document Detail


Low-molecular-weight heparin in pregnancy: peripartum bleeding complications.
MedLine Citation:
PMID:  17443203     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare bleeding complications in pregnant patients treated with low-molecular-weight heparin (LMWH) to untreated controls. STUDY DESIGN: A case-control study of patients from 2001 to 2005 who received prophylactic or therapeutic doses of LMWH during pregnancy was carried out. Indications for LMWH included current or prior thromboembolism, thrombophilia, or heart valve replacement. Controls were chosen in a 2:1 ratio to cases, matched for delivery route, and selected as the next two consecutive deliveries. The primary outcome was postpartum hemorrhage (PPH). Odds ratios (ORs) were calculated with 95% confidence intervals (CIs). RESULTS: Forty-nine women treated with LMWH delivered 55 infants. Current or prior thromboembolic disease was the anticoagulation indication in 15/55 (27.3%) and 26/55 (47%) of pregnancies, respectively. There were more obese gravidas (OR 3.91, CI 1.70 to 9.09) and labor induction was more common in the LMWH group, 25/55 (45%) vs 29/110 (26%), P=0.01. There was no difference in estimated blood loss (295.7+/-145.7 vs 308.6+/-111.9 cm(3), P=0.62 vaginal; 687.5+/-251.8 vs 765.0+/-313.2 cm(3), P=0.34 cesarean), PPH (6/55, 11% vs 9/110, 8.2% OR 1.37, CI 0.16 to 11.5) or transfusion (3/55, 5.4% vs 4/110, 3.6% OR 1.50, CI 0.3 to 7.48) between the cases and controls. There were two cases of postpartum pulmonary emboli, one with a maternal mortality. CONCLUSION: Bleeding complications, including PPH and transfusion, in patients treated with LMWH during pregnancy were not increased when compared to normal controls matched for delivery route.
Authors:
M A Kominiarek; S M Angelopoulos; N L Shapiro; L Studee; E A Nutescu; J U Hibbard
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Publication Detail:
Type:  Journal Article     Date:  2007-04-19
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  27     ISSN:  0743-8346     ISO Abbreviation:  J Perinatol     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-05-24     Completed Date:  2007-07-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  329-34     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, College of Medicine, University of Illinois Medical Center at Chicago, IL 60607, USA. mkomin1@uic.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Anticoagulants / administration & dosage,  adverse effects*
Case-Control Studies
Female
Heparin, Low-Molecular-Weight / administration & dosage,  adverse effects*
Humans
Illinois / epidemiology
Infant, Newborn
Postpartum Hemorrhage / chemically induced,  epidemiology*
Pregnancy
Pregnancy Complications, Cardiovascular / prevention & control*
Pregnancy Outcome
Risk Factors
Thromboembolism / prevention & control*
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Heparin, Low-Molecular-Weight

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