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Anticoagulation during pregnancy.

Ingrid Pabinger1, Helga Grafenhofer

  • 1Department of Hematology and Blood Coagulation, University Clinic I, University Hospital Vienna, Vienna, Austria. ingrid.pabinger@akh-wien.ac.at

Seminars in Thrombosis and Hemostasis
|January 14, 2004
PubMed
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Pregnancy significantly increases the risk of venous thromboembolism (VTE). Anticoagulation with heparin is crucial for pregnant women with VTE, especially those with antiphospholipid syndrome or a history of clots.

Area of Science:

  • Obstetrics and Gynecology
  • Hematology
  • Cardiology

Background:

  • Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in pregnancy and postpartum.
  • Pregnancy increases VTE risk fivefold, with higher risks postpartum and in women with specific risk factors like antiphospholipid antibodies or prior VTE.

Purpose of the Study:

  • To review the risks and management of VTE during pregnancy and the puerperium.
  • To discuss the role of anticoagulation in managing VTE and related pregnancy complications.

Main Methods:

  • Literature review and synthesis of existing evidence on VTE in pregnancy.
  • Analysis of treatment strategies, including heparin and aspirin, for VTE and pregnancy-related thrombotic events.

Main Results:

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  • Heparin is the anticoagulant of choice during pregnancy as it does not cross the placenta.
  • Prophylactic anticoagulation is recommended for high-risk pregnant individuals, including those with hereditary antithrombin deficiency, antiphospholipid antibodies, or a history of severe VTE.
  • Combination therapy with heparin and aspirin is effective in reducing fetal loss in antiphospholipid syndrome.

Conclusions:

  • VTE management during pregnancy requires careful consideration of maternal and fetal risks.
  • Anticoagulation strategies, particularly heparin, are vital for preventing and treating VTE in pregnant women.
  • Further research is needed on the role of heparin in recurrent miscarriage and optimizing anticoagulation for women with artificial heart valves.