[Anticoagulation and antiaggregation during pregnancy]

Area of Science:

• Obstetrics and Gynecology
• Hematology
• Pharmacology

Background:

• Pregnancy significantly elevates thrombotic risk by approximately six-fold.
• Thrombophilias are increasingly recognized as risk factors for severe obstetric complications, including preeclampsia, placental abruption, and fetal growth restriction.
• Antithrombotic medication is often considered for pregnant women facing acute thromboembolism or requiring prophylaxis against thrombosis and obstetric complications.

Purpose of the Study:

• To review the use of antithrombotic medications in pregnancy.
• To discuss the risks and benefits of coumarins, heparins, and aspirin during pregnancy.
• To identify low molecular weight heparins as the anticoagulants of choice for most indications in pregnant patients.

Main Methods:

• Review of existing literature on antithrombotic therapy in pregnancy.
• Analysis of pregnancy-related issues associated with coumarins, heparins, and aspirin.
• Evaluation of specific situations and protocols for using antithrombotic medications during pregnancy.

Main Results:

• Low molecular weight heparins are identified as the preferred anticoagulants for the majority of indications in pregnancy.
• The article details the pregnancy-related challenges and considerations for using coumarins, heparins, and aspirin.
• Guidance is provided on when and how to use these antithrombotic medications based on individual risk profiles.

Conclusions:

• Antithrombotic therapy in pregnancy requires careful consideration of individual risk profiles and potential side effects.
• Low molecular weight heparins offer a favorable risk-benefit profile for most antithrombotic needs during pregnancy.
• Effective management of thrombotic risk in pregnancy involves tailored therapeutic strategies.