Posts Tagged ‘Pregnancy’
Stephan Moll, MD writes…
The injectable low molecular weight heparins (LMWH; e.g. enoxaparin = Lovenox; dalteparin = Fragmin; tinzaparin = Innohep) are the preferred blood thinners in the pregnant patient. Warfarin is to be avoided as it can cause malformations of the fetus and can lead to bleeding in the unborn.
Regarding breastfeeding: the low molecular weight heparins (listed above) and warfarin are safe in the woman who is beastfeeding.
Rivaroxaban (Xarelto), dabigatran (Pradaxa) and apixaban (Eliquis) should not be used during pregnancy or while breastfeeding.
A detailed summary about the safety of each blood thinner during pregnancy and while breast-feeding, based on the ACCP 2012 guidelines [ref], can be found here.
Bates SM, Greer IA, Middeldorp S et al. VTE, Thrombophilia, Antithrombotic Therapy, and Pregnancy. Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. CHEST 2012; 141(2)(Suppl):e691S–e736S.
Disclosure: I have consulted for Janssen and Boehringer-Ingelheim.
Last updated: Jan 23rd, 2014
A new guideline about the prevention, diagnosis, and treatment of DVT and PE associated with pregnancy was published today by ACOG (American College of Obstetricians and Gynecologists) in its respected series of Practice Bulletins. The bulletin also takes detailed reference to prevention of blood clots in pregnant women with thrombophilia. Read the rest of this entry »
How common is pregnancy loss? What are the causes?
Pregnancy loss (= miscarriage) in the general population is common. Most losses occur in the first trimester. As many as 5 % of women have 2 or more early losses; 1-2 % have 3 or more early losses [ref 1]. Well established risk factors for pregnancy loss are: (a) advanced age of the mother, (b) anatomic abnormalities of the uterus (such as fibroids), (c) chromosome abnormalities of fetus, the mother or the father, (d) underlying diseases of the mother (endocrine, immunologic), (e) maternal hormonal unbalances. The acquired clotting disorder called “antiphospholipid antibody syndrome” is also a risk factor for pregnancy loss. The role of inherited clotting disorders (= thrombophilias) contributing to pregnancy loss is less clear. Read the rest of this entry »