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Published on: July 7, 2011
The Safety of Low-Molecular-Weight Heparin During and After Pregnancy
Eric Lu1, Joseph J Shatzel2, Jennifer Salati3
1Internal Medicine Resident, Department of Medicine.
Importance:
In industrialized countries, venous thromboembolism remains a leading cause of mortality in pregnant women. Low-molecular-weight heparin (LMWH) is the most commonly recommended anticoagulant in pregnancy, having been proven effective and safe in multiple prospective clinical trials.
Objective:
The aim of this article is to outline existing recommendations for proper use of LMWH in pregnancy and data on risks of LMWH.
Evidence Acquisition:
Wereviewed guidelines froma number of professional societies.We also examined the current literature behind the various risks associated with LMWH use.
Results:
Our review outlines the current data that guide the use of LMWH in pregnancy. With prophylactic dosing, LMWH comes with a 0.5% risk of antepartum bleeding and a 1% risk of postpartum hemorrhage that is not different from clinical trial controls. With treatment dosing, there is a 1.5% risk of antepartum bleeding and a 2% risk of postpartum hemorrhage. Overall, current evidence behind these risks is limited, and this review suggests areas of further study moving forward.
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