Prophylaxis of thromboembolism in pregnancy: an alternative

Twenty-six pregnancies in women who had one or more episodes of thromboembolism in the past were managed by a regimen in which routine antenatal prophylactic anticoagulation was not given, apart from during delivery which was covered with intravenous infusion of dextran 70. After delivery, these patients received either subcutaneous heparin for 6 weeks or subcutaneous heparin for 1 week, followed by 5 weeks of warfarin. One patient (4%) possibly developed an episode of thromboembolism in the antenatal period. There were no episodes of postnatal thromboembolism. There were two spontaneous mid-trimester abortions and no perinatal losses. There were no significant complications or reactions related to the use of dextran, heparin or warfarin.