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Updated: Aug 20, 2026

Real-time Monitoring of Reactions Performed Using Continuous-flow Processing: The Preparation of 3-Acetylcoumarin as an Example
Published on: November 18, 2015
Adherence to a guideline for coumarins in pregnancy
Dieneke van Driel1, Judit Wesseling, Kirsten ter Huurne
1Department of Paediatrics, Beatrix Children's Hospital, University Hospital, Groningen, The Netherlands.
Objective:
To asses the adherence in daily clinical practice to a guideline for anticoagulation during pregnancy.
Methods:
The Dutch anticoagulation clinics developed a pregnancy guideline for anticoagulant therapy in order to avoid foetal exposure to coumarins between the 6th and 9th week of gestation. Anticoagulation was studied in 282 prospectively-registered pregnant women, who were treated by 26 different anticoagulation clinics.
Results:
The guideline was adhered to in 93% of treated women. Conforming to the guideline, the majority of patients commenced anticoagulation with heparin in the first trimester (n = 81) or started treatment from the second trimester onwards (n = 168). At the time of conception, 31 anticoagulated women were on coumarin treatment. In 13 of these patients (42%), coumarins were withdrawn before the 6th gestational week. In two pregnant women coumarin therapy started unintentionally during the first trimester of gestation.
Conclusion:
The present study shows that the guideline under study is useful in daily clinical practice. A careful instruction of women of child-bearing age who need medication remains important.
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