Where do we go now with low molecular weight heparin use in obstetric care?

Journal of Thrombosis and Haemostasis

Volumn 6, Issue 9, 2008, Pages 1461-1467

  Patel, J P ^a   Hunt, Beverley J ^b  

^a KING'S COLLEGE LONDON   (United Kingdom)

^b GUY'S AND ST THOMAS' NHS FOUNDATION TRUST   (United Kingdom)

Author keywords

Heparin; Low molecular weight heparins; Obstetrics; Review

Indexed keywords

ACETYLSALICYLIC ACID; COUMARIN; DALTEPARIN; DANAPAROID; ENOXAPARIN; FONDAPARINUX; HEPARIN; LOW MOLECULAR WEIGHT HEPARIN; TINZAPARIN; WARFARIN;

ANTICOAGULANT THERAPY; AREA UNDER THE CURVE; ARTERY THROMBOSIS; CLINICAL TRIAL; DISTRIBUTION VOLUME; DRUG CLEARANCE; DRUG DOSE INCREASE; DRUG EFFICACY; DRUG ELIMINATION; DRUG PREFERENCE; DRUG SAFETY; EMBRYOTOXICITY; GLOMERULUS FILTRATION RATE; HEPARIN INDUCED THROMBOCYTOPENIA; HUMAN; LOW DRUG DOSE; LUNG EMBOLISM; MATERNAL MORTALITY; MAXIMUM PLASMA CONCENTRATION; OBSTETRIC CARE; OPTIMAL DRUG DOSE; OSTEOPOROSIS; PRENATAL PERIOD; PRIORITY JOURNAL; PROSTHETIC VALVE THROMBOSIS; REVIEW; RISK ASSESSMENT; SECOND TRIMESTER PREGNANCY; THIRD TRIMESTER PREGNANCY; THROMBOSIS PREVENTION; TIME TO MAXIMUM PLASMA CONCENTRATION; VENOUS THROMBOEMBOLISM;

ANTICOAGULANTS; DRUG MONITORING; FEMALE; GREAT BRITAIN; HEART VALVE PROSTHESIS; HEPARIN, LOW-MOLECULAR-WEIGHT; HUMANS; OBSTETRICS; PREGNANCY; PREGNANCY COMPLICATIONS, HEMATOLOGIC; VENOUS THROMBOEMBOLISM;

EID: 49849101762     PISSN: 15387933     EISSN: 15387836     Source Type: Journal    
DOI: 10.1111/j.1538-7836.2008.03048.x     Document Type: Review

References (53)

1. Greer IA, Nelson-Piercy C. Low-molecular weight heparins for prophylaxis and treatment of venous thromboembolism during pregnancy: A systematic review of safety and efficacy. Blood 2005; 106: 401-7.
2. van Dongen CJJJ, van den Belt AGM, Prins MH, Lensing AWA. Fixed dose subcutaneous low molecular weight heparin versus adjusted dose unfractionated heparin for venous thromboembolism (review). Cochrane Database Syst Rev 2004; 4: CD001100.
3. Greer IA, Hunt BJ. Low molecular weight heparin in pregnancy: Current issues. Br J Haematol 2005; 128: 593-601.
4. Copplestone JA, Pavord S, Hunt BJ. Anticoagulation in pregnancy: A survey of current practice. Br J Haematol 2004; 124: 123-5.
5. Voke KM, Keidan J, Parvod S, Spencer NH, Hunt BJ. The management of antenatal venous thromboembolism in the UK and Ireland: A prospective multi-centre survey. Br J Haematol 2007; 139: 545-58.
6. Sanson BJ, Lensing AW, Prins MH, Ginsberg JS, Barkagan ZS, Lavenne-Pardonge E, Brenner B, Dulitzky M, Nielsen JD, Boda Z, Turi S, Mac Gillavry MR, Hamulyák K, Theunissen IM, Hunt BJ, Büller HR. Safety of low-molecular-weight heparin in pregnancy: A systematic review. Thromb Haemost 1999; 81: 668-72.
7. Dawes M, Chowienczyk PJ. Pharmacokinetics in pregnancy. Best Pract Res Clin Obstet Gynaecol 2001; 15: 819-26.
8. Davison JM, Nobel MCB. Serial changes in 24hour creatinine clearance during normal menstrual cycles and the first trimester of pregnancy. Br J Obstet Gynaecol 1981; 88: 10-7.
9. Anderson GD. Pregnancy-induced changes in pharmacokinetics: A mechanistic-based approach. Clin Pharmacokinet 2005; 44: 989-1008.
10. Royal College of Obstetricians and Gynaecologists. Thromboembolic Disease in Pregnancy and the Puerperium: Acute Management. Guideline no.28 Update. London: RCOG Press, 2007. Available at http://www.rcog.org.uk.
11. Blomback M, Bremme K, Hellgren M, Lindberg H. A Pharmacokinetic study of Dalteparin (Fragmin) during late pregnancy. Blood Coagul Fibrinolysis 1998; 9: 343-50.
12. Casele HL, Laifer SA, Woelkers DA, Venkataramanan R. Changes in the pharmacokinetics of the low molecular weight heparin enoxaparin sodium during pregnancy. Am J Obstet Gynecol 1999; 181: 1113-7.
13. Eriksson BI, Soderberg K, Widlund W, Wandeli B, Tengborn L, Risberg B. A comparative study of three low molecular weight heparins (LMWH) and unfractionated heparin (UH) in healthy volunteers. Thromb Res 1995; 73: 398-401.
14. Royal College of Obstetricians, and Gynaecologists. Thromboembolic Disease During Pregnancy and Puerperium: Acute Management. London: RCOG Press, 2001.
15. Bates SM, Greer IA, Hirsh J, Ginsberg JS. Use of antithrombotic agents during pregnancy: The seventh ACCP conference on antithrombotic and thrombolytic therapy. Chest 2004; 126: 627-44.
16. Merli G, Spiro TE, Olsson C-G, Abildgaard U, Davidson BL, Eldor A, Elias D, Andrew Grigg A, Musset D, Rodgers GM, Trowbridge AA, Yusen RD, Zawilska K. Subcutaneous Enoxaparin once or twice daily compared with intravenous unfractionated heparin for treatment of venous thromboembolic disease. Ann Intern Med 2001; 134: 191-202.
17. Smith MP, Norris LA, Steer PJ, Savidge GF, Bonnar J. Tinzaparin sodium for thrombosis treatment and prevention during pregnancy. Am J Obstet Gynecol 2004; 190: 495-501.
18. White RH, Ginsberg JS. Low molecular weight heparins: Are they all the same. Br J Haematol 2003; 121: 12-20 (Review).
19. Laizorovicz A, Bara L, Samama MM, Haugh MC. Factor Xa inhibition: correlation between the plasma levels of anti-Xa activity and occurrence of thrombosis and haemorrhage. Haemostasis 1993; 23 (Suppl. 1): 89-98.
20. Kitchen S, Lampietro R, Woolley AM, Preston FE. Anti-Xa monitoring during treatment of LMWH or danaparoid: Inter-assay variability. Thromb Haemost 1999; 82: 1289-93.
21. Nelson-Piercy C, Letsky EA, de Swiet M. Low molecular weight heparin for obstetric thromboprophylaxis: Experience of sixty-nine pregnancies in sixty-one women at high risk. Am J Obstet Gynecol 1997; 176: 1062-8.
22. Ellison J, Walker ID, Greer IA. Antenatal use of enoxaparin for prevention and treatment of thromboembolism in pregnancy. Br J Obstet Gynaecol 2000; 107: 1116-21.
23. Hunt BJ, Doughty H, Majurndar G, Copplestone A, Kerslake S, Buchanan N, Hughes G, Khamashta M. Thromboprophylaxis with low molecular weight heparin (dalteparin) in high risk pregnancies. Thromb Haemost 1997; 77: 39-43.
24. Knight M, UKOSS. Antenatal pulmonary embolism: Risk factors, management and outcomes. Br J Obstet Gynaecol 2008; 115: 453-61.
25. CEMACH. Why Mothers Die 2000-2002. The Sixth Report of the Confidential Enquiries Into Maternal Deaths in the United Kingdom. London: RCOG Press, 2004.
26. Royal College of Obstetricians and Gynaecologists. Report of the RCOG Working Party on Prophylaxis Against Thromboembolism in Gynaecology and Obstetrics. London: RCOG press, 1995.
27. Royal College of Obstetricians and Gynaecologists. Thromboprophylaxis During Pregnancy, Labour & After Vaginal Delivery. Guideline no.37. London: RCOG Press, http://www.rcog.org.uk, 2004.
28. Scottish Intercollegiate Guidelines Network (SIGN). Prophylaxis of Venous Thromboembolism - A National Clinical Guideline (No 62), October 2002.
29. Gates S, Brocklehurst P, Davis LJ. Prophylaxis for venous thromboembolic disease in pregnancy and the early postnatal period. Cochrane Database Syst Rev 2002; CD001689.
30. Derksen RHWM, de Groot PG, Kappelle LJ. Low dose aspirin after ischaemic stroke associated with antiphospholipid syndrome. Neurology 2003; 61: 111-4.
31. Khamashta MA, Cuadrado MJ, Taub NA, Hunt BJ, Hughes GR. The management of thrombosis in the antiphospholipid-antibody syndrome. N Engl J Med 1995; 332: 993-7.
32. Rosove MH, Brewer PMC. Antiphospholipid thrombosis: Clinical course after the first thrombotic event in 70 patients. Ann Intern Med 1992; 117: 303-8.
33. Crowther MA, Ginsberg JS, Julian J, Denburg J, Hirsh J, Douketis J, Laskin C, Fortin P, Anderson D, Kearon C, Clarke A, Geerts W, Forgie M, Green D, Costantini L, Yacura W, Wilson S, Gent M, Kovacs MJ. A comparison of two intensities of warfarin for the prevention of recurrent thrombosis in patients with the antiphospholipid antibody syndrome. N Engl J Med 2003; 349: 1133-8.
34. Finazzi G, Marchioli R, Brancaccio V, Schinco P, Wisloff F, Musial J, Baudo F, Berrettini M, Testa S, D'Angelo A, Tognoni G, Barbui T. A randomized clinical trial of high intensity warfarin versus conventional antithrombotic therapy for the prevention of recurrent thrombosis in patients with the antiphospholipid syndrome. J Thromb Haemost 2005; 3: 848-53.
35. Rickles FR, Marder VJ. Moderate dose oral anticoagulant therapy in patients with the antiphospholipid syndrome? J Thromb Haemost 2005; 3: 842-3.
36. Rai R, Cohen H, Dave M, Regan L. Randomised controlled trial of aspirin and aspirin plus heparin in pregnant women with recurrent miscarriage associated with phospholipid antibodies (or antiphospholipid antibodies). Br Med J 1997; 314: 253-7.
37. Farquharson RG, Quenby S, Greaves M. Antiphospholipid syndrome in pregnancy: A randomized, controlled trial of treatment. Obstet Gynecol 2002; 100: 408-13.
38. Chan WS, Anand S, Ginsberg JS. Anticoagulation of pregnant women with mechanical heart valves - a systematic review of the literature. Arch Intern Med 2000; 160: 191-6.
39. Sadler L, McCowan L, White H, Stewart A, Bracken M, North R. Pregnancy outcomes and cardiac complications in women with mechanical, bioprosthetic and homograft valves. Br J Obstet Gynaecol 2000; 107: 245-53.
40. Hall JG, Pauli RM, Wilson KM. Maternal and fetal sequelae of anticoagulation during pregnancy. Am J Med 1980; 68: 122-40.
41. Ginsberg JS, Hirsh J, Turner DC, Levine MN, Burrows R. Risks to the foetus of anticoagulation therapy during pregnancy. Thromb Haemost 1989; 61: 197-203.
42. http://www.fda.gov/medwatch/SAFETY/2002/lovenox.htm (accessed 18th November 2007).
43. Enoxaparin (Clexane) - Summary of Product Characteristics. Sanofi-Aventis, March 2007 http://emc.medicines.org.uk/ (accessed 10th December 2007).
44. James AH, Brancazio LR, Gehrig TR, Wang A, Ortel TL. Low molecular weight heparin for thromboprophylaxis in pregnant women with mechanical heart valves. J Matern Fetal Neonatal Med 2006; 19: 543-9.
45. Ginsberg JS, Chan WS, Bates SM, Kaatz S. Anticoagulation of pregnant women with mechanical heart valves. Arch Intern Med 2003; 163: 694-8.
46. Goldsmith I, Turpie AGG, Lip GYH. ABC of antithrombotic therapy: Valvar heart disease and prosthetic heart valves. Br Med J 2002; 325: 1228-31.
47. Green B, Duffull SB. Developing a dosing strategy for enoxaparin in obese patients. Br J Clin Pharmacol 2003; 56: 96-103.
48. Fondaparinux (Arixtra) - Summary of Product Characteristics. Glaxosmithkline, November 2007 http://emc.medicines.org.uk/ (accessed 10th December 2007).
49. Lagrange F, Vergnes C, Brun JL, Paolucci F, Nadal T, Leng JJ, Saux MC, Banwarth B. Absence of placental transfer of pentasaccharide (Fondaparinux, Arixtra) in the dually perfused human cotyledon in vitro. Thromb Haemost 2002; 87: 831-5.
50. Dempfle CE. Minor transplacental passage of fondaparinux in vivo. N Engl J Med 2004; 350: 1914-5.
51. Mazzolai L, Hohlfeld P, Spertini F, Hayoz D, Schapira M, Duchosal MA. Fondaparinux is a safe alternative in case of heparin intolerance during pregnancy. Blood 2006; 108: 1569-70.
52. Harenberg J. Treatment of a woman with lupus and thromboembolism and cutaneous intolerance to heparins using fondaparinux during pregnancy (letter). Thromb Res 2007; 119: 385-8.
53. Gerhardt A, Zotz RB, Stockschlaeder M, Scharf RE. Fondaparinux is an effective alternative anticoagulant in pregnant women with high risk of venous thromboembolism and intolerance to low-molecular-weight heparins and heparinoids. Thromb Haemost 2007; 97: 496-7.