Fondaparinux in pregnancy: Could it be a safe option? A review of the literature

Carolis, Sara De; Pasquo, E. di; Rossi, Elio; Sordo, Gelsomina Del; Buonomo, Alessandro; Schiavino, Domenico; Lanzone, Antonio; Stefano, Valerio De

doi:10.1016/j.thromres.2015.04.001

Cited by 43 publications

(25 citation statements)

References 20 publications

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“…A review of fondaparinux use in pregnant women with a high risk of thrombosis showed that in 65 pregnancies, fondaparinux was well tolerated and the rate of pregnancy complications was similar to that observed in general populations. Pregnancy was interrupted because of fetal abnormalities in one case . Reportedly, fondaparinux does not pass through human placenta in vitro , but a few placental transfers and a shift to a fetus can be seen in rats in vivo .…”

Section: Discussionmentioning

confidence: 95%

Use of fondaparinux for thromboprophylaxis in an unfractionated heparin‐intolerant pregnant woman with thrombotic predisposition

Shoji

Maruta

Nakajima

et al. 2017

J of Obstet and Gynaecol

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A 34-year-old primigravida who had undergone thrombectomy for deep venous thrombosis (DVT) in her leg and exhibited low protein S activity, indicating predisposition to thrombosis, developed DVT of the leg. No pulmonary embolism was detected. After anticoagulant therapy with unfractionated heparin was discontinued because of liver dysfunction, danaparoid treatment was administered in hospital. The patient had a normal delivery after 39 weeks' gestation with no recurrence of thrombosis. During her second pregnancy four years later, she gave herself fondaparinux injections. She delivered normally after 38 weeks' gestation without experiencing DVT. Fondaparinux may be a useful anticoagulant for heparin-intolerant pregnant women.

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Section: Discussionmentioning

confidence: 95%

Use of fondaparinux for thromboprophylaxis in an unfractionated heparin‐intolerant pregnant woman with thrombotic predisposition

Shoji

Maruta

Nakajima

et al. 2017

J of Obstet and Gynaecol

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“…More data are required to assess the risk of congenital malformations with fondaparinux. [ 49 , 50 ]…”

Section: Considerations Regarding Anticoagulation Therapy During Pregmentioning

confidence: 99%

“…Given the scarce evidence on the use of fondaparinux in pregnancy, together with possible minor transplacental passage, its use should be limited to cases of documented allergy or adverse response to LMWH. More data are required to assess the risk of congenital malformations with fondaparinux 49,50. Systemic embolisation may occur in up to 10-20% of patients with MS, with the highest risk in patients with AF.…”

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confidence: 99%

Management of Valvular Disease During Pregnancy: Evolving Role of Percutaneous Treatment

et al. 2020

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Valvular heart disease (VHD) is encountered in approximately 1% of pregnancies, significantly increasing both maternal and foetal risk. Rheumatic VHD remains the most common form in non-Western countries, whereas congenital heart disease dominates in the Western world. The risk of complications varies according to the type and severity of the underlying VHD. Moreover, pregnancy is a hypercoagulable state associated with increased risk of thromboembolism. The authors review the main VHDs encountered during pregnancy, and suggest management strategies based on the 2018 European Society of Cardiology recommendations for the management of pregnant women with VHD, providing an overview of classical and new transcatheter structural therapeutic options with a special focus on radiation exposure and anticoagulation drug management.

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“…Direct oral anticoagulants including dabigatran, rivaroxaban and apixaban have the potential to cross the placenta with unknown fetal effects, and hence are not currently recommended in pregnancy (93). In women with allergic reactions to LMWH or UFH or with a history of heparin induced thrombocytopenia (HIT), fondaparinux may be considered as an alternative (94). Fondaparinux appears to cross the placenta in small quantities, but the significance of this is unclear and reports of the successful use of fondaparinux in pregnancy have been published (95).…”

Section: Risk Factorsmentioning

confidence: 99%

“…Fondaparinux appears to cross the placenta in small quantities, but the significance of this is unclear and reports of the successful use of fondaparinux in pregnancy have been published (95). Evaluation of the risk and benefit is still necessary particularly when considering use in the first trimester (94).…”

Section: Pathophysiologymentioning

confidence: 99%

Therapeutic heparin during the peripartum period

North¹

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Fondaparinux in pregnancy: Could it be a safe option? A review of the literature

Cited by 43 publications

References 20 publications

Use of fondaparinux for thromboprophylaxis in an unfractionated heparin‐intolerant pregnant woman with thrombotic predisposition

Use of fondaparinux for thromboprophylaxis in an unfractionated heparin‐intolerant pregnant woman with thrombotic predisposition

Management of Valvular Disease During Pregnancy: Evolving Role of Percutaneous Treatment

Therapeutic heparin during the peripartum period

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