Document Detail


Venous thromboembolism in pregnancy: prophylaxis and treatment with low molecular weight heparin.
MedLine Citation:
PMID:  19916891     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the safety of individually dosed low molecular weight heparin (LMWH) for prophylaxis and treatment of thromboembolic complications in pregnancy. DESIGN: Cohort study with a chronologic register-based control group. SETTING: Department of Obstetrics and Gynecology, Hillerød Hospital, Denmark. POPULATION: All 166 women treated with LMWH in pregnancy between 1 January 2001 and 31 December 2005. METHODS: Women treated with LMWH in pregnancy were identified and individual case records reviewed retrospectively. General data on the LMWH-treated women were compared to the 18,020 untreated pregnancies within the same period and with 306 matched controls as regards to postpartum hemorrhage (PPH). MAIN OUTCOME MEASURES: Side effects of treatment, thromboembolic manifestations, postpartum bleeding and obstetric outcome. RESULTS: There were no thromboembolic events during therapy, few side effects of treatment and no osteoporotic fractures or episodes of heparin-induced thrombocytopenia. The 166 pregnancies resulted in 159 live infants. There was a significantly higher risk of preterm delivery (13% vs. 6%) and intrauterine growth restriction (4.4% vs. 3.5%). Delivery by cesarean section was more common in these high-risk LMWH-treated pregnancies (33.1%) than in untreated pregnancies (19.2%). In the LMWH-group, the occurrence of PPH was 7.2% compared with 8.8% in the matched untreated control group (p = 0.675). None of the events in the LMWH group were serious and all 166 women were in good health at discharge. CONCLUSIONS: Individually dosed LMWH is well tolerated and safe for prophylaxis and treatment of thromboembolic complications during pregnancy, delivery and the postpartum period.
Authors:
Anita Sylvest Andersen; Jørgen G Berthelsen; Thomas Bergholt
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  89     ISSN:  1600-0412     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2010  
Date Detail:
Created Date:  2009-12-21     Completed Date:  2010-01-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  15-21     Citation Subset:  IM    
Affiliation:
Department of Gynecology and Obstetrics, Hillerød Hospital, Hillerød, Denmark. asan@noh.regionh.dk
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MeSH Terms
Descriptor/Qualifier:
Adult
Anticoagulants / administration & dosage*
Cesarean Section / statistics & numerical data
Dalteparin / administration & dosage
Female
Fetal Growth Retardation / epidemiology
Fibrinolytic Agents / administration & dosage
Gestational Age
Heparin, Low-Molecular-Weight / administration & dosage*
Humans
Obstetric Labor, Premature / epidemiology
Pregnancy
Pregnancy Complications, Cardiovascular / drug therapy*,  prevention & control
Pregnancy Outcome
Retrospective Studies
Venous Thromboembolism / drug therapy*,  prevention & control
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Dalteparin; 0/Fibrinolytic Agents; 0/Heparin, Low-Molecular-Weight; 0/tinzaparin

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