The use of fondaparinux in pregnancy

Elsaigh, Esra; Thachil, Jecko; Nash, Michael J.; Tower, Clare; Hay, C. R. M.; Bullough, Sian; Byrd, L

doi:10.1111/bjh.13147

Cited by 23 publications

(18 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…For example, efficacy and safety of fondaparinux have been found to be comparable with intravenous UH in the treatment of PE (Büller et al, 2003), LMWH in VTE prophylaxis after major orthopedic surgery (Donath et al, 2012), and LMWH in non-STEMI, whereby bleeding risk was found to be lower with fondaparinux (Szummer et al, 2015). Fondaparinux is reported to have been used successfully during pregnancy in the case of hypersensitivity to heparin (Elsaigh et al, 2015), but it is not currently recommended because of the lack of safety data in this setting .…”

Section: E Fondaparinux and Other Alternativesmentioning

confidence: 99%

Pharmacology of Heparin and Related Drugs

et al. 2015

View full text Add to dashboard Cite

Section: E Fondaparinux and Other Alternativesmentioning

confidence: 99%

Pharmacology of Heparin and Related Drugs

et al. 2015

View full text Add to dashboard Cite

“…In this woman, who weighed 99 kg and suffered from three previous VTE events, the initial dose of fondaparinux was 7,5 mg daily. Considering that the recommended dose is 10 mg for weight 100 kg, it could be considered that the recurrent DVT was due to inadequate anticoagulation, rather than treatment failure [15]. As the number of women receiving fondaparinux because of a history of previous DVT was 27, the failure rate for this indication was 3.7% (95% CI; 0.6%-18.3%).…”

Section: Contents Lists Available At Sciencedirectmentioning

confidence: 99%

“…Out of 68 pregnancies so far reported [6,7,[9][10][11][12][13][14][15][16] (Table 1), three were considered not evaluable, because in two cases fondaparinux …”

mentioning

confidence: 99%

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

Carolis

Pasquo

Rossi

et al. 2015

Thrombosis Research

View full text Add to dashboard Cite

“…Elsaigh et al reported on the use of fondaparinux in 13 women and 15 pregnancies [82]. Nine patients received treatment at therapeutic doses (7.5 or 10 mg/d), and six patients were treated with a lower prophylactic dose (2.5 or 5 mg/d).…”

Section: Heparin-induced Thrombocytopeniamentioning

confidence: 99%

Treatment of pregnancy-associated venous thromboembolism - position paper from the Working Group in Women’s Health of the Society of Thrombosis and Haemostasis (GTH)

Linnemann

Scholz

Rott

et al. 2016

Vasa

View full text Add to dashboard Cite

Summary: Venous thromboembolism (VTE) is a major cause of maternal morbidity during pregnancy and the postpartum period. However, because there is a lack of adequate study data, management strategies for pregnancy-associated VTE must be deduced from observational studies and extrapolated from recommendations for non-pregnant patients. In this review, the members of the Working Group in Women's Health of the Society of Thrombosis and Haemostasis (GTH) have summarised the evidence that is currently available in the literature to provide a practical approach for treating pregnancy-associated VTE. Because heparins do not cross the placenta, weight-adjusted therapeutic-dose low molecular weight heparin (LMWH) is the anticoagulant treatment of choice in cases of acute VTE during pregnancy. No differences between once and twice daily LMWH dosing regimens have been reported, but twice daily dosing seems to be advisable, at least peripartally. It remains unclear whether determining dose adjustments according to factor Xa activities during pregnancy provides any benefi t. Management of delivery deserves attention and mainly depends on the time interval between the diagnosis of VTE and the expected delivery date. In particular, if VTE manifests at term, delivery should be attended by an experienced multidisciplinary team. In lactating women, an overlapping switch from LMWH to warfarin is possible. Anticoagulation should be continued for at least 6 weeks postpartum or for a minimum period of 3 months. Although recommendations are provided for the treatment of pregnancy-associated VTE, there is an urgent need for well-designed prospective studies that compare different management strategies and defi ne the optimal duration and intensity of anticoagulant treatment. Anticoagulant therapy during pregnancyLow-molecular-weight heparins (LMWH) are considered the anticoagulants of choice in pregnancy-associated VTE because LMWH do not cross the placenta and do not appear at signifi cant levels in breast milk. Although a Cochrane Review stated that there was no evidence from randomised controlled trials regarding the effi cacy of anticoagulant therapy for DVT in pregnancy [2], two systemic reviews of LMWH use in pregnant women have confi rmed their efficacy and safety, which were consistent with those in nonpregnant women [3,4]. Compared to unfractionated heparin (UFH), LMWH were associated with a substantially lower risk of adverse side eff ects, such as heparin-induced thrombocytopenia (HIT), haemorrhage, and osteoporosis [3 -7]. However, UFH may be considered an alternative if LMWH cannot be used or if UFH seems to be advantageous over LMWH, e.g., in women at high risk of bleeding complications or in women with severe renal impairment. Women with confi rmed PE and haemodynamic compromise who are candidates for subsequent thrombolysis should also receive UFH during the initial phase until defi nitive treatment decisions are reached [1]. Data obtained from non-pregnant patients have confi rmed that LMWH are at least as eff ective...

show abstract

The use of fondaparinux in pregnancy

Cited by 23 publications

References 8 publications

Pharmacology of Heparin and Related Drugs

Pharmacology of Heparin and Related Drugs

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

Treatment of pregnancy-associated venous thromboembolism - position paper from the Working Group in Women’s Health of the Society of Thrombosis and Haemostasis (GTH)

Contact Info

Product

Resources

About