Long-term therapy with subcutaneous heparin during pregnancy

Area of Science:

• Obstetrics and Gynecology
• Hematology
• Pharmacology

Background:

• Thromboembolic complications (TE) pose risks during pregnancy.
• Heparin is a common anticoagulant used in managing TE.
• Understanding heparin's safety and effects during pregnancy is crucial.

Purpose of the Study:

• To evaluate the safety and efficacy of heparin in pregnant women with acute TE or for TE prophylaxis.
• To assess maternal complications, fetal outcomes, and specific laboratory parameters during heparin therapy.

Main Methods:

• Retrospective analysis of 35 pregnant women (37 pregnancies) treated with subcutaneous and/or intravenous heparin.
• Monitoring for thromboembolic complications, bleeding events, and pregnancy outcomes.
• Analysis of antithrombin III (AT) levels, platelet counts, and liver function in a subset of patients.

Main Results:

• No serious bleeding complications were observed.
• The most frequent maternal complication was incipient premature labor (7 women).
• Heparin treatment did not appear to adversely affect fetal outcomes.
• A transient decrease in AT levels was noted initially, with normalization during long-term treatment.
• Platelet counts and liver function remained largely unchanged.

Conclusions:

• Heparin can be safely administered to pregnant women for acute TE or prophylaxis.
• Close monitoring for complications like premature labor is warranted.
• Heparin therapy does not significantly impact fetal development or cause major hematological/hepatic dysfunction in the long term.