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Posts Tagged ‘Pregnancy’

Pregnancy, Breast-Feeding: Safety of the Various Blood Thinners

| Arixtra - Fondaparinux, Eliquis - Apixaban, Pradaxa - dabigatran, warfarin / coumadin, Xarelto - Rivaroxaban | Comments Off on Pregnancy, Breast-Feeding: Safety of the Various Blood Thinners

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.

Click image above for a detailed summary about the safety of each blood thinner during pregnancy and breastfeeding.

Reference

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

Pregnancy Loss and Clotting Disorders

| Antiphospholipid antibodies, Antithrombin deficiency, Clotting disorder - thrombophilia, Factor V Leiden, Protein C deficiency, Protein S deficiency, Prothrombin 20210 mutation, Therapy, Women and blood clots | 8 Comments »

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 »