Document Detail


The use of low-molecular-weight heparins in pregnancy--how safe are they?
MedLine Citation:
PMID:  18007136     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: Low-molecular-weight heparins are in widespread use during pregnancy. As with every treatment in pregnant patients, concerns have been raised about the safety of Low-molecular-weight heparins. The purpose of the present article is to review recent advances, published during the past year, that have studied the maternal, fetal, and neonatal safety of Low-molecular-weight heparins in pregnant women. RECENT FINDINGS: Low-molecular-weight heparins do not increase the risk of maternal bleeding during pregnancy. Closed management is needed during the peripartum period, and discontinuing Low-molecular-weight heparins at least 12 h before delivery seems sufficient to prevent post-partum haemorrhage. The incidence of Low-molecular-weight heparins-induced immune reaction is low. Fondaparinux or danaparoid may be used as an alternative option in pregnant women with heparin-induced thrombocytopenia. Long-term Low-molecular-weight heparins therapy may be associated with osteopenia. Calcium vitamin D supplementation during pregnancy may reduce the risk of Low-molecular-weight heparins-induced osteoporosis. As Low-molecular-weight heparins do not cross the placenta, no fetal or neonatal complication has been reported. Beyond the safety question, Low-molecular-weight heparins have the potential to improve the live-birth rate in high-risk pregnancies (antiphospholipid syndrome, thrombophilia, or recurrent fetal loss). SUMMARY: Recent studies have confirmed the safety of Low-molecular-weight heparins therapy during pregnancy. The risk of potential side effects is low for both the mother and the neonate.
Authors:
Philippe Deruelle; Capucine Coulon
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in obstetrics & gynecology     Volume:  19     ISSN:  1040-872X     ISO Abbreviation:  Curr. Opin. Obstet. Gynecol.     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-11-16     Completed Date:  2008-02-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9007264     Medline TA:  Curr Opin Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  573-7     Citation Subset:  IM    
Affiliation:
Clinique d'Obstétrique. Hôpital Jeanne de Flandre, CHRU de Lille, France. p-derulle@chru-lille.fr
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MeSH Terms
Descriptor/Qualifier:
Anticoagulants / adverse effects*,  therapeutic use
Bone Density Conservation Agents / administration & dosage*
Bone Diseases, Metabolic / prevention & control
Calcium, Dietary / administration & dosage
Female
Heparin, Low-Molecular-Weight / adverse effects*,  therapeutic use
Humans
Postpartum Hemorrhage / prevention & control
Pregnancy
Pregnancy Complications, Hematologic / drug therapy*
Pregnancy Outcome
Risk Assessment
Safety
Thrombocytopenia / chemically induced,  prevention & control
Thrombosis / prevention & control*
Vitamin D / administration & dosage
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Bone Density Conservation Agents; 0/Calcium, Dietary; 0/Heparin, Low-Molecular-Weight; 1406-16-2/Vitamin D

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