A less-intensive anticoagulation protocol of therapeutic unfractionated heparin administration for pregnant patients

Neki, Reiko; Mitsuguro, Mana; Okamoto, Akira; Ida, Kazufumi; Miyoshi, Takekazu; Kamiya, Chizuko; Iwanaga, Naoki; Miyata, Toshiyuki; Yoshimatsu, Jun

doi:10.1007/s12185-019-02712-z

Cited by 3 publications

(4 citation statements)

References 25 publications

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“…Anticoagulant therapy and its management during pregnancy is often difficult. 54 It is suggested that Japanese be given more moderate doses than Caucasians (Table 3). 54,55 Specifically, after loading with heparin of 80 units/kg, continuous intravenous infusion of UFH is started at 15 units/kg/h.…”

Section: Commentarymentioning

confidence: 99%

“…54 It is suggested that Japanese be given more moderate doses than Caucasians (Table 3). 54,55 Specifically, after loading with heparin of 80 units/kg, continuous intravenous infusion of UFH is started at 15 units/kg/h. Activated partial thromboplastin time (APTT) is measured 4 h after the start of the UFH continuous intravenous infusion, and the flow rate is adjusted while watching the APTT.…”

Section: Commentarymentioning

confidence: 99%

“…The UFH infusion is discontinued 6 h before the start of the planned delivery or C-section, and delivery is carried out after confirming that APTT has normalized. 54,77,78 A fair number of women need anesthesia at the time of delivery either when a C-section is to be performed or with the increasing number of painless childbirths in recent years. Therefore, it is recommended that the following should be considered in advance with regard to anesthesia for the management of pregnancy and delivery in thrombophilia patients, many of whom receive anticoagulant therapy.…”

Section: Commentarymentioning

confidence: 99%

“…Less-intensive body-weight adjusted intravenous UFH dosing protocol for pregnant patients54,55 Step 1. Initial UFH dose Intravenous bolus at 80 U/kg, and then 15 U/kg/h by continuous infusion for 4 hStep 2.…”

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confidence: 99%

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Clinical guidance for peripartum management of patients with hereditary thrombophilia

Kobayashi

Morishita

Tsuda

et al. 2021

J of Obstet and Gynaecol

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Hereditary thrombophilia is a condition in which individuals are susceptible to the formation of thrombi due to a hereditary deficiency in anticoagulant factors, antithrombin (AT), protein C (PC), or protein S (PS). Many Japanese thrombophilia patients have PS deficiency, especially PS p.K196E (also called as PS Tokushima), which is exclusive to the Japanese population, and thrombosis sometimes occurs during pregnancy. At present, no management guidelines for pregnancy and delivery in thrombophilia patients have been developed. The Study Group for Hereditary Thrombophilia, one of the research groups of blood coagulation abnormalities in the Research Program on Rare and Intractable Diseases supported with the Research Grants of the Ministry of Health, Labour and Welfare Science, has therefore developed this clinical guidance to provide healthcare workers with necessary information on safe pregnancy, parturition and neonatal management, adopting a format of responses to seven clinical questions (CQ). At the end of each answer, the corresponding Recommendation Level (A, B, C) is indicated.

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Section: Commentarymentioning

confidence: 99%

Section: Commentarymentioning

confidence: 99%