Low Molecular Weight Heparin and Warfarin in the Treatment of Patients with Antiphospholipid Syndrome during Pregnancy

Rachel Pauzner; Mordechai Dulitzki; Pnina Langevitz; Avi Livneh; Ron Kenett; Amira Many

doi:10.1055/s-0037-1616739

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2001; 86(06): 1379-1384
DOI: 10.1055/s-0037-1616739

Review Article

Schattauer GmbH

Low Molecular Weight Heparin and Warfarin in the Treatment of Patients with Antiphospholipid Syndrome during Pregnancy

Authors

Rachel Pauzner

Sheba Medical Center, Sackler School of Medicine and School of Engineering, Tel-Aviv University, Israel
Mordechai Dulitzki

Sheba Medical Center, Sackler School of Medicine and School of Engineering, Tel-Aviv University, Israel
Pnina Langevitz

Sheba Medical Center, Sackler School of Medicine and School of Engineering, Tel-Aviv University, Israel
Avi Livneh

Sheba Medical Center, Sackler School of Medicine and School of Engineering, Tel-Aviv University, Israel
Ron Kenett

Sheba Medical Center, Sackler School of Medicine and School of Engineering, Tel-Aviv University, Israel
Amira Many

Sheba Medical Center, Sackler School of Medicine and School of Engineering, Tel-Aviv University, Israel

Abstract

Summary

Fifty-seven pregnancies in women with antiphospholipid syndrome (APS) are presented. These were treated with s.c. enoxaparin and low dose aspirin. In fourteen pregnancies warfarin was prescribed between weeks 15-34 (warfarin group). The decision to switch to warfarin depended on a morbidity score, and the patient’s consent. Neither teratogenicity nor significant maternal, fetal or neonatal hemorrhage was observed. Despite the higher pretreatment morbidity score of the warfarin group, the live birth rate was high in both groups: 86% in the warfarin group and 87% in the non-warfarin group. There was no significant difference in week of delivery, birth weight, or incidence of thrombosis between the groups. The study demonstrates the efficacy and safety of anticoagulants during pregnancy. The use of LMWH in pregnant women with APS not being moot, warfarin might be justified in selected patients.

Keywords

Antiphospholipid syndrome - pregnancy - low molecular weight heparin - warfarin

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Referenzen

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