Safety of Low-Molecular-Weight Heparin in Pregnancy: A Systematic Review

Bernd-Jan Sanson; Anthonie W. A. Lensing; Martin H. Prins; Jeffrey S. Ginsberg; Zinoviy S. Barkagan; Edith Lavenne-Pardonge; Benjamin Brenner; Mordechay Dulitzky; Jørn D. Nielsen; Zoltan Boda; Susanna Turi; Melvin R. Mac Gillavry; Karly Hamulyák; Ingrid M. Theunissen; Beverley J. Hunt; Harry R. Büller

doi:10.1055/s-0037-1614550

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 1999; 81(05): 668-672
DOI: 10.1055/s-0037-1614550

Review Article

Schattauer GmbH

Safety of Low-Molecular-Weight Heparin in Pregnancy: A Systematic Review

Authors

Bernd-Jan Sanson

¹From the Department of Vascular Medicine and The Netherlands
Anthonie W. A. Lensing

¹From the Department of Vascular Medicine and The Netherlands
Martin H. Prins

²Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, Amsterdam, The Netherlands
Jeffrey S. Ginsberg

³Department of Medicine, McMaster University, Hamilton, Ontario, Canada
Zinoviy S. Barkagan

⁴Siberian Regional Center on Thrombosis and Hemostasis, Altai Medical University, Barnaul, Russia
Edith Lavenne-Pardonge

⁵Department of Hemostasis, Catholic University of Louvain, Brussels, Belgium
Benjamin Brenner

⁶Thrombosis and Hemostasis Unit, Rambam Medical Center, Haifa, Israel
Mordechay Dulitzky

⁷Department of Gynecology and Obstetrics, Sheba Medical Center, Tel Aviv, Israel
Jørn D. Nielsen

⁸Coagulation Laboratory and Thrombosis Center, Gentofte Hospital, Hellerup, Denmark
Zoltan Boda

⁹2nd Department of Medicine, University of Debrecen, Hungary
Susanna Turi

¹⁰Department of Gynecology and Obstetrics, I. Haynal University School of Health Sciences, Budapest, Hungary
Melvin R. Mac Gillavry

¹¹Department of Internal Medicine, Slotervaart Hospital, Amsterdam, The Netherlands
Karly Hamulyák

¹²Department of Internal Medicine, University Hospital of Maastricht, The Netherlands
Ingrid M. Theunissen

⁵Department of Hemostasis, Catholic University of Louvain, Brussels, Belgium
Beverley J. Hunt

¹³The Rayne Institute, St Thomas’ Hospital, London, The United Kingdom
Harry R. Büller

¹From the Department of Vascular Medicine and The Netherlands

Abstract

Summary

Unfractionated heparin (UFH) remains the anticoagulant of choice during pregnancy. Low-molecular-weight heparins (LMWH) are an attractive alternative to UFH due to their logistic advantages and their association with a lower incidence of osteoporosis and HIT. We reviewed all published clinical reports concerning the use of LMWH during pregnancy. In addition, participants of an international interest group contributed a cohort of pregnant women treated with LMWH. Pregnancies were divided into two groups; those with and those without maternal comorbid conditions. The number of adverse fetal outcomes and the occurrence of maternal complications were evaluated in the two groups. In the group of women with comorbid conditions (n = 290), 13.4% of the pregnancies were associated with an adverse fetal outcome. In contrast, in the group of women without comorbid conditions (n = 196), 3.1% were associated with an adverse outcome, which is comparable to that seen in the normal population. We conclude that LMWH appear to be a safe alternative to unfractionated heparin as an anticoagulant during pregnancy.

Full Text

References

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