The Safety of Low-Molecular-Weight Heparin during and after Pregnancy

Eric Lu, Joseph J. Shatzel, Jennifer Salati, Thomas Deloughery

    Research output: Contribution to journalArticle

    1 Citation (Scopus)

    Abstract

    Importance In industrialized countries, venous thromboembolism remains a leading cause of mortality in pregnant women. Low-molecular-weight heparin (LMWH) is the most commonly recommended anticoagulant in pregnancy, having been proven effective and safe in multiple prospective clinical trials. Objective The aim of this article is to outline existing recommendations for proper use of LMWH in pregnancy and data on risks of LMWH. Evidence Acquisition We reviewed guidelines from a number of professional societies. We also examined the current literature behind the various risks associated with LMWH use. Results and Conclusions Our review outlines the current data that guide the use of LMWH in pregnancy. With prophylactic dosing, LMWH comes with a 0.5% risk of antepartum bleeding and a 1% risk of postpartum hemorrhage that is not different from clinical trial controls. With treatment dosing, there is a 1.5% risk of antepartum bleeding and a 2% risk of postpartum hemorrhage. Overall, current evidence behind these risks is limited, and this review suggests areas of further study moving forward. Target Audience Obstetricians and gynecologists, family physicians. Learning Objectives After completing this activity, the learner should be better able to define the specific risk factors and preexisting conditions that would warrant LMWH use in pregnancy and postpartum; describe the different available doses of LMWH, when to use each dose, and when monitoring is appropriate; and discuss the risks of anticoagulation with LMWH during various stages of pregnancy and birth.

    Original languageEnglish (US)
    Pages (from-to)721-729
    Number of pages9
    JournalObstetrical and Gynecological Survey
    Volume72
    Issue number12
    DOIs
    StatePublished - Dec 1 2017

    Fingerprint

    Low Molecular Weight Heparin
    Safety
    Pregnancy
    Postpartum Hemorrhage
    Clinical Trials
    Hemorrhage
    Preexisting Condition Coverage
    Venous Thromboembolism
    Family Physicians
    Developed Countries
    Anticoagulants
    Postpartum Period
    Pregnant Women
    Learning
    Parturition
    Guidelines
    Mortality

    ASJC Scopus subject areas

    • Obstetrics and Gynecology

    Cite this

    The Safety of Low-Molecular-Weight Heparin during and after Pregnancy. / Lu, Eric; Shatzel, Joseph J.; Salati, Jennifer; Deloughery, Thomas.

    In: Obstetrical and Gynecological Survey, Vol. 72, No. 12, 01.12.2017, p. 721-729.

    Research output: Contribution to journalArticle

    Lu, Eric ; Shatzel, Joseph J. ; Salati, Jennifer ; Deloughery, Thomas. / The Safety of Low-Molecular-Weight Heparin during and after Pregnancy. In: Obstetrical and Gynecological Survey. 2017 ; Vol. 72, No. 12. pp. 721-729.
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