Related Experiment Video
Updated: Jan 16, 2026
07:39
Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
Published on: August 16, 2021
4.1K
Managing anticoagulation peripartum
Arielle L Langer1, Brandon Togioka2, Nicole A Smith3
1Division of Hematology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Women's Health, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Journal of Thrombosis and Haemostasis : JTH
|September 27, 2025
Summary
Managing anticoagulation during pregnancy requires careful planning to balance thrombosis risks with postpartum hemorrhage concerns. Personalized delivery strategies involving multiple specialists ensure safe outcomes for expectant mothers on anticoagulants.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Anesthesiology
Background:
- Anticoagulants are frequently used during pregnancy due to increased thrombosis risk.
- Peripartum anticoagulation management is complex, requiring a balance between therapeutic benefits and hemorrhage risks.
- Neuraxial anesthesia availability can be limited for patients on anticoagulation.
Purpose of the Study:
- To outline key considerations for delivery planning in pregnant patients on anticoagulation.
- To emphasize the importance of multidisciplinary collaboration for safe peripartum anticoagulation management.
- To review postpartum anticoagulation strategies for venous thromboembolism.
Main Methods:
- Review of current literature and clinical guidelines on peripartum anticoagulation.
- Discussion of factors influencing delivery decisions, including dosing, delivery mode, and anesthesia.
- Consideration of patient preferences and specific clinical scenarios.
Main Results:
- Delivery planning involves evaluating prophylactic vs. therapeutic dosing, delivery mode, and timing.
- Patient-specific factors like neuraxial anesthesia indications and patient values are crucial.
- Transitioning to different anticoagulation methods (e.g., heparin infusions) may be necessary before delivery.
Conclusions:
- Optimal peripartum anticoagulation requires prenatal collaboration among thrombosis experts, obstetricians, and anesthesiologists.
- Personalized delivery plans are essential to mitigate thrombosis and hemorrhage risks while respecting patient preferences.
- Adherence to postpartum anticoagulation is critical during this high-risk period.
Related Concept Videos
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
1.7K
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
1.7K
01:29Venous Thrombosis III: Interprofessional Care
280
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
280
01:30Venous Thrombosis IV: Nursing Management
201
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
201
01:18Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
2.1K
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
2.1K
01:22Aneurysm IV: Nursing Management
380
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
380
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
287
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
287