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Massive subchorionic hematoma associated with enoxaparin.

Richard H Lee1, T Murphy Goodwin

  • 1Los Angeles County-University of Southern California Medical Center, Women's and Children's Hospital, Los Angeles, CA 90033, USA. richardl@usc.edu

Obstetrics and Gynecology
|October 5, 2006
PubMed
Summary
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Subchorionic hematoma is a rare but serious complication that can occur during pregnancy when using enoxaparin for thromboembolism prevention. Careful monitoring is crucial for pregnant patients on anticoagulation therapy.

Area of Science:

  • Obstetrics and Gynecology
  • Cardiology
  • Pharmacology

Background:

  • Increasing use of low-molecular-weight heparins in pregnancy for thromboembolism prevention.
  • Subchorionic hematoma is a rarely reported complication of anticoagulation therapy during pregnancy.

Observation:

  • A case of persistent, massive subchorionic hematoma in a pregnant patient with atrial fibrillation and mitral stenosis.
  • Enoxaparin was administered, maintaining trough anti-Xa levels at 0.5 units/mL or higher, with peak levels not exceeding 1.05 units/mL.

Findings:

  • Diagnosis of a massive subchorionic hematoma in a pregnant patient receiving therapeutic enoxaparin.
  • The patient delivered via cesarean section at 34 6/7 weeks due to preterm premature rupture of membranes.

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Implications:

  • Subchorionic hematoma is a potential serious complication in pregnant patients on enoxaparin.
  • Highlights the importance of vigilance for obstetric complications during anticoagulation therapy in pregnancy.
  • Further research may be needed to understand the risk factors and management of subchorionic hematoma in this population.