Outcomes in women receiving low-molecular-weight heparin during pregnancy

Sancho, Maria Teresa De; Khalid, Sana; Christos, Paul J.

doi:10.1097/mbc.0b013e328358e92c

Cited by 9 publications

(2 citation statements)

References 23 publications

(26 reference statements)

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“…Thus, similarly as in the previous study, such significant increase in the LMWH dose requirements in the prophylactic group indicates more frequent need of monitoring of anti-Xa activity to keep target anticoagulant level. 94,95 Most commonly, target peak anti-Xa activity in the treatment group was in the range 0.6 to 1.0 IU/mL and between 0.2 to 0.4 IU/mL in the prophylatic group. 72,96,97 These target ranges are similar to those used as the reference ranges in our study (0.2-0.4 IU/mL for the prophylactic dose of LMWH and 0.5-1.2 IU/mL for the therapeutic dose).…”

Section: Discussionmentioning

confidence: 99%

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How can Secondary Thromboprophylaxis in High-Risk Pregnant Patients be Improved?

Stančiaková

Dobrotová

Holly

et al. 2022

Clin Appl Thromb Hemost

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Low-molecular-weight heparin (LMWH) is suggested for thromboprophylaxis in pregnant women with previous venous thromboembolism (VTE). Anyway, there is only limited amount of studies evaluating the effect of LMWH on hemostatic parameters during pregnancy of patients with previous VTE and the need of secondary thromboprophylaxis. We therefore provide results of prospective and longitudinal assessment of changes in hemostasis in high-risk pregnant women at four times during pregnancy (T1–T4) and one time after the postpartum period (T5) used for individualized modification of thromboprophylaxis. In this study, the results of coagulation factor VIII (FVIII) and protein S (PS) activity, ProC Global ratio and anti-Xa activity were evaluated. Despite the thromboprophylaxis, an increased predisposition to thromboembolic complications was detected (significant increase in FVIII activity and decrease in PS function, ProC Global ratio not normalized even after the postpartum period – p < .0001 between controls and T5 for PS and ProC Global). These results indicate that hemostasis may not be restored even 6 to 8 weeks after delivery and pose the question when is it safe to withdraw the anticoagulant thromboprophylaxis in high-risk patients with prior VTE.

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