| Prophylaxis with low-dose low-molecular-weight heparin during pregnancy and postpartum: is it effective? | |
| | |
MedLine Citation:
|
PMID: 21232006 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: The optimal approach for venous thrombosis (VTE) prophylaxis during pregnancy and postpartum in women with an increased risk of VTE is not established. OBJECTIVES: To evaluate the effectiveness, represented as the incidence of pregnancy-related VTE, and safety, represented as incidence of postpartum hemorrhage (PPH), of a protocol recommending prophylaxis with low-dose low-molecular-weight heparin (LMWH) in women at intermediate to high risk of VTE. PATIENTS/METHODS: In this retrospective cohort study, we analyzed 34 women (44 pregnancies) with intermediate risk of VTE who received low-dose LMWH for 6 weeks postpartum and 57 women (82 pregnancies) with high risk of VTE who received low-dose LMWH during pregnancy and for 6 weeks postpartum. Pregnancy-related VTE was defined as VTE during pregnancy or ≤ 3 months postpartum. PPH was defined as blood loss >500 mL and severe PPH as blood loss > 1000 mL. RESULTS: The incidence of pregnancy-related VTE was 5.5% (95% CI, 2.4-12.3) despite prophylaxis with low-dose LMWH. All events occurred in women at high risk, with a postpartum incidence of 7.0% (95% CI, 2.9-16.7) and antepartum incidence of 1.8% (95% CI, 0.4-9.2). The risk of PPH was 21.6% (95% CI, 14.3-31.3) and severe PPH 9.1% (95% CI, 4.7-16.9), which was not different in women who started LMWH postpartum and those who used LMWH during pregnancy. CONCLUSIONS: Although prophylaxis with low-dose LMWH during pregnancy and postpartum proved to be safe, the risk of pregnancy-related VTE is considerable in women with a high risk of VTE. VTE prophylaxis with low-dose LMWH may not be sufficiently effective in these women. |
| | |
Authors:
|
J E Roeters van Lennep; E Meijer; F J C M Klumper; J M Middeldorp; K W M Bloemenkamp; S Middeldorp |
Related Documents
:
|
19626026 - Previous cesarean section and the risk of postpartum maternal complications and adverse... 10685206 - Congenital chylothorax in neonatal thyrotoxicosis. 3534256 - Neonatal myotonic dystrophy associated with prenatal ventriculomegaly. a case report. 19694696 - Fetal extrasystole may predict poor neonatal outcome. 417336 - Notes on comparative reproduction of selected callitrichidae in the laboratory. 9166706 - Immunolocalization of acidic and basic fibroblast growth factors in porcine uterine and... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Journal of thrombosis and haemostasis : JTH Volume: 9 ISSN: 1538-7836 ISO Abbreviation: J. Thromb. Haemost. Publication Date: 2011 Mar |
Date Detail:
|
Created Date: 2011-03-01 Completed Date: 2011-06-21 Revised Date: 2011-11-03 |
Medline Journal Info:
|
Nlm Unique ID: 101170508 Medline TA: J Thromb Haemost Country: England |
Other Details:
|
Languages: eng Pagination: 473-80 Citation Subset: IM |
Copyright Information:
|
© 2011 International Society on Thrombosis and Haemostasis. |
Affiliation:
|
Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands. j.roetersvanlennep@erasmusmc.nl |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Anticoagulants / adverse effects, pharmacology Cohort Studies Female Heparin, Low-Molecular-Weight / adverse effects, pharmacology* Humans Postpartum Hemorrhage / etiology Pregnancy Pregnancy Complications, Cardiovascular / prevention & control* Puerperal Disorders / prevention & control Retrospective Studies Risk Factors Venous Thromboembolism / complications, prevention & control |
| Chemical | |
Reg. No./Substance:
|
0/Anticoagulants; 0/Heparin, Low-Molecular-Weight |
| Comments/Corrections | |
Comment In:
|
J Thromb Haemost. 2011 Jun;9(6):1269-71; author reply 1272-3
[PMID:
21489132
]
J Thromb Haemost. 2011 Aug;9(8):1669-70 [PMID: 21645230 ] J Thromb Haemost. 2011 Oct;9(10):2127-9; author reply 2129-30 [PMID: 21736699 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: New gene variants associated with venous thrombosis - a replication study in United States whites an...
Next Document: Haemostatic cardiovascular risk factors, common carotid intima medial thickness and peripheral arter...