Anticoagulant Therapy During Pregnancy and Gynecology

Hemostasis and Thrombosis in Obstetrics & Gynecology

Volumn , Issue , 2011, Pages 111-152

  Rodger, Marc A ^a,b   Le Templier, Genevieve ^c  

^a UNIVERSITY OF OTTAWA   (Canada)

^b Thrombosis and Thrombophilia Ottowa Hospital General   (Canada)

^c OTTAWA HOSPITAL RESEARCH INSTITUTE   (Canada)

Author keywords

D dimer; Heparin; Heparin induced thrombocytopenia; Malignancy; Pregnancy; Pulmonary embolism; Thrombophilia; Venography; Venous thromboembolism; Warfarin

Indexed keywords

EID: 84888754968     PISSN: None     EISSN: None     Source Type: Book    
DOI: 10.1002/9781444328332.ch6     Document Type: Chapter

References (157)

1. Pengo V, Lensing AW, Prins MH, et al. Incidence of chronic thromboembolic pulmonary hypertension after pulmonary embolism. NEngl J Med 2004; 350:2257-64.
2. Dismuke SE. Pulmonary embolism as a cause of death. JAMA 1986; 255:2039-42.
3. Anderson FA Jr., Wheeler HB, Goldberg RJ, et al. A population-based perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism. The Worcester study. Arch Intern Med 1991; 151:933-8.
4. Silverstein MD, Heit JA, Mohr DN, Petterson TM, O'Fallon WM, Melton LJ, III. Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25- year population-based study. Arch Intern Med 1998; 158:585-93.
5. Nordstrom M, Lindblad B. Autopsy-verified venous thromboembolism within a defined urban population-the city of Malmo, Sweden. APMIS 1998; 106(3):378-84.
6. Dalen JE, Alpert JS. Natural history of pulmonary embolism. Prog Cardiovasc Dis 1975; 17:259-70.
7. Carson JL, Kelley MA, Duff A, et al. The clinical course of pulmonary embolism. N Engl J Med 1992; 326:1240-5.
8. Alpert JS, Smith R, Carlson CJ, Ockene IS, Dexter L, Dalen JE. Mortality in patients treated for pulmonary embolism. JAMA 1976; 236:1477-80.
9. Kruip MJHA, Leclercq MGL, Van Der Heul C, Prins MH, Buller HR. Diagnostic strategies for excluding pulmonary embolism in clinical outcome studies: a systematic review. Ann Intern Med 2003; 138:941-51.
10. PIOPED Investigators. Value of the ventilation/perfusion scan in acute pulmonary embolism. Results of the prospective investigation of pulmonary embolism diagnosis (PIOPED). JAMA 1990; 263:2753-9.
11. Wells PS, Ginsberg JS, Anderson DR, et al. Use of a clinical model for safe management of patients with suspected pulmonary embolism. Ann Intern Med 1998; 129:997-1005.
12. Hull RD, Hirsh J, Carter CJ, et al. Pulmonary angiography, ventilation lung scanning, and venography for clinically suspected pulmonary embolism with abnormal perfusion lung scan. Ann Intern Med 1983; 98:891-9.
13. Hildner FJ, Ormond RS. Accuracy of the clinical diagnosis of pulmonary embolism. JAMA 1967; 202:567-70.
14. Stein PD, Terrin ML, Hales CA, et al. Clinical, laboratory, roentgenographic, and electrocardiographic findings in patients with acute pulmonary embolism and no pre-existing cardiac or pulmonary disease. Chest 1991; 100:598-603.
15. Stein PD, Goldhaber SZ, Henry JW. Alveolar-arterial oxygen gradient in the assessment of acute pulmonary embolism. Chest 1995; 107:139-43.
16. Rodger MA, Makropoulos D, Turek M, et al. Diagnostic value of the electrocardiogram in suspected pulmonary embolism. Am J Cardiol 2000; 86:807-9.
17. Wicki J, Perneger TV, Junod AF, Bounameaux H, Perrier A. Assessing clinical probability of pulmonary embolism in the emergency ward: a simple score. Arch Intern Med 2001; 161:92-7.
18. Musset D, Parent F, Meyer G, et al. Diagnostic strategy for patients with suspected pulmonary embolism: a prospective multicentre outcome study. Lancet 2002; 360:1914-20.
19. Miniati M, Prediletto R, Formichi B, et al. Accuracy of clinical assessment in the diagnosis of pulmonary embolism. Am J Respir Crit Care Med 1999; 159:864-71.
20. Wells PS, Anderson DR, Rodger MA, et al. Excluding pulmonary embolism at the bedside without diagnostic imaging: Management of patients with suspected pulmonary embolism presenting to the emergency department by using a simple clinical model and D-dimer. Ann Intern Med 2001; 135:98-107.
21. Rodger MA, Raymond F, Stiell I, et al. Development and validation of a simple clinical prediction rule to exclude pulmonary embolism. Blood 94(10 Suppl. 1):27. 1999. Abstract.
22. Rodger MA, Jones G, Rasuli P, et al. Steady-state end-tidal alveolar dead space fraction and D-dimer: bedside tests to exclude pulmonary embolism. Chest 2001; 120:115-9.
23. Rodger MA, Bredeson CN, Jones G, et al. The bedside investigation of pulmonary embolism diagnosis study: a double-blind randomized controlled trial comparing combinations of 3 bedside tests vs ventilation-perfusion scan for the initial investigation of suspected pulmonary embolism. Arch Intern Med 2006; 166:181-7.
24. Le Gal G, Righini M, Roy PM, et al. Prediction of pulmonary embolism in the emergency department: the revised geneva score. Ann Intern Med 2006; 144:165-71.
25. Kline JA, Wells PS. Methodology for a rapid protocol to rule out pulmonary embolism in the emergency department. Ann Emerg Med 2003; 42:266-76.
26. Kline JA, Meek S, Boudrow D, Warner D, Colucciello SA. Use of the alveolar dead space fraction (Vd/Vt) and plasma D-dimers to exclude acute pulmonary embolism in ambulatory patients. Acad Emerg Med 1997; 4:856-63.
27. Wells PS, Anderson DR, Rodger MA, et al. Derivation of a simple clinical model to categorize patients probability of pulmonary embolism: Increasing the models utility with the SimpliRED D-dimer. Thromb Haemost 2000; 83:416-20.
28. Miniati M, Monti S, Bottai M. A structured clinical model for predicting the probability of pulmonary embolism. Am J Med 2003; 114:173-9.
29. Carrier M, Wells PS, Rodger MA. Excluding pulmonary embolism at the bedside with low pre-test probability and D-dimer: safety and clinical utility of 4 methods to assign pre-test probability. Thromb Res 2006; 117:469-74.
30. Roy PM, Meyer G, Vielle B, et al. Appropriateness of diagnostic management and outcomes of suspected pulmonary embolism. Ann Intern Med 2006; 144:157-64.
31. Kraaijenhagen RA, Lijmer JG, Bossuyt PMM, Prins MH, Heisterkamp SH, Buller HR. The accuracy of D-dimer in the diagnosis of venous thromboembolism: a meta-analysis. In: RA Kraaijenhagen (ed), The Etiology, Diagnosis and Treatment of Venous Thromboembolism. Academic Medical Centre, Amsterdam, 2000, pp. 159- 83.
32. Perrier A. Pulmonary embolism: from clinical presentation to clinical probability assessment. Semin Vasc Surg 2001; 1(2):147-54.
33. Perrier A, Desmarais S, Miron MJ, et al. Non-invasive diagnosis of venous thromboembolism in outpatients. Lancet 1999; 353:190-5.
34. Brotman DJ, Segal JB, Jani JT, Petty BG, Kickler TS. Limitations of D-dimer testing in unselected inpatients with suspected venous thromboembolism. Am J Med 2003; 114:276-82.
35. Perrier A, Roy PM, Sanchez O, et al. Multidetector-row computed tomography in suspected pulmonary embolism. N Engl J Med 2005; 352:1760-8.
36. van Beek EJ, Kuyer PMM, Schenk BE, Brandjes DPM, ten Cate JW, Buller HR. A normal perfusion lung scan in patients with clinically suspected pulmonary embolism: Frequency and clinical validity. Chest 1995; 108:170-3.
37. Hudson ER, Smith TP, McDermott VG, et al. Pulmonary angiography performed with iopamidol: complications in 1,434 patients. Radiology 1996; 198:61-5.
38. Stein PD, Athanasoulis C, Alavi A, et al. Complications and validity of pulmonary angiography in acute pulmonary embolism. Circulation 1992; 85:462-8.
39. Rajendran JG, Jacobson AF. Review of 6-month mortality following lowprobability lung scans. Arch Intern Med 1999; 159:349-52.
40. Rosen MP, Sheiman RG, Weintraub J, McArdle C. Compression sonography in patients with indeterminate or low-probability lung scans: Lack of usefulness in the absence of both symptoms of deep-vein thrombosis and thromboembolic risk factors. AJR Am J Roentgenol 1996; 166:285-9.
41. Wells PS, Anderson DR, Ginsberg JS. Assessment of deep vein thrombosis or pulmonary embolism by the combined use of clinical model and noninvasive diagnostic tests. Semin Thromb Hemost 2000; 26:643-56.
42. Remy-Jardin M, Remy J. Spiral CT angiography of the pulmonary circulation. Radiology 1999; 212:615-36.
43. Mayo JR, Remy-Jardin M, Muller NL, et al. Pulmonary embolism: prospective comparison of spiral CT with ventilation-perfusion scintigraphy. Radiology 1997; 205:447-52.
44. Mullins MD, Becker DM, Hagspiel KD, Philbrick JT. The role of spiral volumetric computed tomography in the diagnosis of pulmonary embolism. Arch Intern Med 2000; 160:293-8.
45. Rathbun SW, Raskob G, Whitsett TL. Sensitivity and specificity of helical computed tomography in the diagnosis of pulmonary embolism: a systematic review. Ann Intern Med 2000; 132:227-32.
46. van Belle A, Buller HR, Huisman MV, et al. Effectiveness of managing suspected pulmonary embolism using an algorithm combining clinical probability, D-dimer testing, and computed tomography. JAMA 2006; 295:172-9.
47. Ghanima W, Almaas V, Aballi S, et al. Management of suspected pulmonary embolism (PE) by D-dimer and multi-slice computed tomography in outpatients: an outcome study. J Thromb Haemost 2005; 3:1926-32.
48. Anderson DR, Wells PS, Kahn SR, et al. Abstract: Computerized-tomographic pulmonary angiography compared with ventilation-perfusion lung scanning as initial diagnostic modality for patients with suspected pulmonary embolism: A randomized controlled trial. Blood 2005; 106:463.
49. Wells PS, Hirsh J, Anderson DR, et al. Accuracy of clinical assessment of deep-vein thrombosis. Lancet 1995; 345:1326-30.
50. Wells PS, Anderson DR, Bormanis J, et al. Value of assessment of pretest probability of deep-vein thrombosis in clinical management. Lancet 1997; 350:1795-1798.
51. Wells PS, Owen C, Doucette S, Fergusson D, Tran H. Does this patient have deep vein thrombosis?. JAMA 2006; 295:199-207.
52. Cogo A, Lensing AWA, Koopman MMW, et al. Compression ultrasonography for diagnostic management of patients with clinically suspected deep vein thrombosis: prospective cohort study. Br Med J 1998; 316:17-20.
53. Stein PD, Henry JW. Prevalence of acute pulmonary embolism among patients in a general hospital and at autopsy. Chest 1995; 108:978-81.
54. Buller HR, Agnelli G, Hull RD, Hyers TM, Prins MH, Raskob GE. Antithrombotic therapy for venous thromboembolic disease: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004; 126(3 Suppl):401S-28S.
55. Konstantinides S, Geibel A, Heusel G, Heinrich F, Kasper W. Heparin plus alteplase compared with heparin alone in patients with submassive pulmonary embolism. N Engl J Med 2002; 347(15):1143-50.
56. Stein PD, Hull RD, Raskob G. Risks for major bleeding from thrombolytic therapy in patients with acute pulmonary embolism: consideration of noninvasive management. Ann Intern Med 1994; 121:313-17.
57. Beer JH, Burger M, Gretener S, Bernard-Bagattini S, Bounameaux H. Outpatient treatment of pulmonary embolism is feasible and safe in a substantial proportion of patients. J Thromb Haemost 2003; 1:186-7.
58. Dager WE, King JH, Branch JM, et al. Tinzaparin in outpatients with pulmonary embolism or deep vein thrombosis. Ann Pharmacother 2005; 39:1182-7.
59. Kovacs MJ, Anderson DR, Morrow B, Gray L, Touchie D, Wells PS. Outpatient treatment of pulmonary embolism with dalteparin. Thromb Haemost 2000; 83:209-11.
60. Gould MK, Dembitzer AD, Doyle RL, Hastie TJ, Garber AM. Low-molecular-weight heparins compared with unfractionated heparin for treatment of acute deep venous thrombosis. A meta-analysis of randomized, controlled trials. Ann Intern Med 1999; 130:800-9.
61. Rodger MA, Bredeson CN, Wells PS, Beck J, Kearns B, Huebsch L. Costeffectiveness of low-molecular-weight heparin and unfractionated heparin in treatment of deep vein thrombosis. CMAJ 1998; 159:931-8.
62. Kearon C, Ginsberg JS, Anderson DR, et al. A Comparison of 1 month with 3 months of anticoagulation for a first episode of venous thromboembolism associated with a transient risk factor. J Thromb Haemost 2004; 2:743-9.
63. Douketis JD, Kearon C, Bates SM, Duku EK, Ginsberg JS. Risk of fatal pulmonary embolism in patients with treated venous thromboembolism. JAMA 1998; 279:458-62.
64. Calder KK, Herbert M, Henderson SO. The mortality of untreated pulmonary embolism in emergency department patients. Ann Emerg Med 2005; 45:302- 10.
65. Levine MN, Raskob G, Landefeld S, Kearon C. Hemorrhagic complications of anticoagulant treatment. Chest 2001; 119(1 Suppl):108S-21S.
66. Pinede L, Duhaut P, Cucherat M, Ninet J, Pasquier J, Boissel JP. Comparison of long versus short duration of anticoagulant therapy after a first episode of venous thromboembolism: a meta-analysis of randomized, controlled trials. J Intern Med 2000; 247:553-62.
67. Pinede L, Ninet J, Duhaut P, et al. Comparison of 3 and 6 months of oral anticoagulant therapy after a first episode of proximal deep vein thrombosis or pulmonary embolism and comparison of 6 and 12 weeks of therapy after isolated calf deep vein thrombosis. Circulation 2001; 103:2453-60.
68. Kearon C. Two years of Warfarin versus placebo following three months of anticoagulation for a first episode of idiopathic thromboembolism (VTE). Thromb Haemost Suppl[June], 1997: 767.
69. Kearon C, Gent M, Hirsh J, et al. Extended anticoagulation compared to placebo after three months of therapy for a first episode of idiopathic venous thromboembolism. N Engl J Med 1999; 340:901-7.
70. Agnelli G, Prandoni P, Santamaria MG, et al. Three months versus one year of oral anticoagulant therapy for idiopathic deep venous thrombosis. Warfarin Optimal Duration Italian Trial Investigators. N Engl J Med 2001; 345:165-9.
71. Research Committee of the British Thoracic Society. Optimum duration of anticoagulation for deep-vein thrombosis and pulmonary embolism. Lancet 1992; 340(8824):873-6.
72. Schulman S, Rhedin AS, Lindmarker P, et al. A comparison of six weeks with six months of oral anticoagulant therapy after a first episode of venous thromboembolism. Duration of Anticoagulation Trial Study Group. N Engl J Med 1995; 332:1661-5.
73. Geerts WH, Bergqvist D, Pineo GF, et al. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-based Clinical Practice Guidelines. (8th ed). Chest 2008; 133:381-453.
74. Sachs BP, Brown DA, Driscoll SG, et al. Maternal mortality inMassachusetts. Trends and prevention. N Engl J Med 1987; 316:667-72.
75. de Swiet M. Maternal mortality: confidential enquiries into maternal deaths in the United Kingdom. Am J Obstet Gynecol 2000; 182(4):760-6.
76. Rochat RW. Maternal mortality in the United States of America. World Health Stat Q 1981; 34(1):2-13.
77. Syverson CJ, Chavkin W, Atrash HK, Rochat RW, Sharp ES, King GE. Pregnancyrelated mortality in New York City, 1980 to 1984: causes of death and associated risk factors. Am J Obstet Gynecol 1991; 164:603-8.
78. Koonin LM, Atrash HK, Rochat RW, Smith JC. Maternal mortality surveillance, United States, 1980-1985. Mor Mortal Wkly Rep 1988; 37:19-29.
79. Rochat RW, Koonin LM, Atrash HK, Jewett JF. Maternal mortality in the United States: report from the Maternal Mortality Collaborative. Obstet Gynecol 1988; 72:91-7.
80. Moses V, DePersio SR, Lorenz D, Oberle MW, Rochat R, Fermo A. A thirty-year review of maternal mortality in Oklahoma, 1950 through 1979. Am J Obstet Gynecol 1987; 157:1189-1194.
81. Buehler JW, Kaunitz AM, Hogue CJ, Hughes JM, Smith JC, Rochat RW. Maternal mortality in women aged 35 years or older: United States. JAMA 1986; 255:53-7.
82. Kaunitz AM, Hughes JM, Grimes DA, Smith JC, Rochat RW, Kafrissen ME. Causes of maternal mortality in the United States. Obstet Gynecol 1985; 65:605-12.
83. Department of Health WO, Scottish Department of Health. Why mothers die. Report on confidential enquiries into maternal deaths in the United Kingdom 1994-1996. J Drife, G Lewis (eds), London, The Stationary Office, 1998.
84. Atrash HK, Koonin LM, Lawson HW, Franks AL, Smith JC. Maternal mortality in the United States, 1979-1986. Obstet Gynecol 1990; 76:1055-60.
85. Andersen BS, Steffensen FH, Sorensen HT, Nielsen GL, Olsen J. The cumulative incidence of venous thromboembolism during pregnancy and puerperium. An 11 year Danish population-based study of 63,300 pregnancies. Acta Obstet Gynecol Scand 1998; 77:170-3.
86. Treffers PE, Huidekoper BL, Weenink GH, et al. Epidemiologic observations of thromboembolic disease during pregnancy and in the puerperium in 56,022 women. Int J Gynaecol Obstet 1983; 21:327-31.
87. Gherman RB, Goodwin TM, Leung B, Byrne JD, Hethumumi R, Montoro M. Incidence, clinical characteristics, and timing of objectively diagnosed venous thromboembolism during pregnancy. Obstet Gynecol 1999; 94(5 Pt 1):730-4.
88. Simpson EL, Lawrenson RA, Nightingale AL, Farmer RD. Venous thromboembolism in pregnancy and the puerperium: incidence and additional risk factors from a London perinatal database. BJOG 2001; 108:56-60.
89. Ray JG, Chan WS. Deep vein thrombosis during pregnancy and the puerperium: a meta-analysis of the period of risk and the leg of presentation. Obstet Gynecol Surv 1999; 54:265-71.
90. Bergqvist A, Bergqvist D, Matzsch T, Lindhagen A. Late symptoms after pregnancyrelated deep vein thrombosis. Br J Obstet Gynaecol 1990; 97:338-41.
91. Clark P, Brennand J, Conkie JA, McCall F, Greer IA, Walker ID. Activated protein C sensitivity, protein C, protein S and coagulation in normal pregnancy. Thromb Haemost 1998; 79(6):1166-70.
92. Rosenkranz A, Hiden M, Leschnik B, et al. Calibrated automated thrombin generation in normal uncomplicated pregnancy. Thromb Haemost 2008; 99(2):331-337.
93. Macklon NS, Greer IA, Bowman AW. An ultrasound study of gestational and postural changes in the deep venous system of the leg in pregnancy. Br J Obstet Gynaecol 1997; 104:191-197.
94. Jacobsen AF, Skjeldestad FE, Sandset PM. Ante- and postnatal risk factors of venous thrombosis: a hospital-based case-control study. J Thromb Haemost 2008; 6:905-912.
95. Gerhardt A, Scharf RE, Beckmann MW, et al. Prothrombin and factor V mutations in women with a history of thrombosis during pregnancy and the puerperium. N Engl J Med 2000; 342(6):374-80.
96. Martinelli I, De Stefano V, Taioli E, Paciaroni K, Rossi E, Mannucci PM. Inherited thrombophilia and first venous thromboembolism during pregnancy and puerperium. Thromb Haemost 2002; 87:791-5.
97. Friederich PW, Sanson BJ, Simioni P, et al. Frequency of pregnancy-related venous thromboembolism in anticoagulant factor-deficient women: implications for prophylaxis. Ann Intern Med 1996; 125:955-60.
98. McColl MD, Ramsay JE, Tait RC, et al. Risk factors for pregnancy associated venous thromboembolism. Thromb Haemost 1997; 78(4):1183-8.
99. Brill-Edwards P, Ginsberg JS, Gent M, et al. Safety of withholding heparin in pregnant women with a history of venous thromboembolism. Recurrence of Clot in This Pregnancy Study Group. N Engl J Med 2000; 343:1439-44.
100. Danilenko-Dixon DR, Heit JA, Silverstein MD, et al. Risk factors for deep vein thrombosis and pulmonary embolism during pregnancy or post partum: a population-based, case-control study. Am J Obstet Gynecol 2001; 184:104-10.
101. Ginsberg JS, Hirsh J, Rainbow AJ, Coates G. Risks to the fetus of radiologic procedures used in the diagnosis of maternal venous thromboembolic disease. Thromb Haemost 1989; 61(2):189-96.
102. Bergqvist A, Bergqvist D, Hallbook T. Deep vein thrombosis during pregnancy. A prospective study. Acta Obstet Gynecol Scand 1983; 62:443-448.
103. Kjellberg U, Andersson NE, Rosen S, Tengborn L, Hellgren M. APC resistance and other haemostatic variables during pregnancy and puerperium. Thromb Haemost 1999; 81(4):527-31.
104. Chan WS, Chunilal S, Lee A, Crowther M, Rodger M, Ginsberg JS. A red blood cell agglutination D-dimer test to exclude deep venous thrombosis in pregnancy. Ann Intern Med 2007; 147:165-70.
105. Chan WS, Lee A, Spencer FA, et al. Predicting deep venous thrombosis in pregnancy: out in "LEFt" field?. Ann Intern Med 2009; 151:85-92.
106. Hull RD, Raskob GE, Carter CJ. Serial impedance plethysmography in pregnant patients with clinically suspected deep-vein thrombosis. Clinical validity of negative findings. Ann Intern Med 1990; 112:663-7.
107. Chan WS, Ray JG, Murray S, Coady GE, Coates G, Ginsberg JS. Suspected pulmonary embolism in pregnancy: clinical presentation, results of lung scanning, and subsequent maternal and pediatric outcomes. Arch Intern Med 2002; 162:1170-5.
108. Anderson DR, Kahn SR, Rodger MA, et al. Computed tomographic pulmonary angiography vs ventilation-perfusion lung scanning in patients with suspected pulmonary embolism: a randomized controlled trial. JAMA 2007; 298:2743-53.
109. Levine MN, Hirsh J, Gent M, et al. A randomized trial comparing activated thromboplastin time with heparin assay in patients with acute venous thromboembolism requiring large daily doses of heparin. Arch Intern Med 1994; 154:49-56.
110. Ginsberg JS, Hirsh J. Use of antithrombotic agents during pregnancy. Chest 1998; 114:524S-30S.
111. Couturaud F, Julian JA, Kearon C. Low molecular weight heparin administered once versus twice daily in patients with venous thromboembolism: ameta-analysis. Thromb Haemost 2001; 86:980-4.
112. Dolovich LR, Ginsberg JS, Douketis JD, Holbrook AM, Cheah G. A meta-analysis comparing low-molecular-weight Heparins with unfractionated heparin in the treatment of venous thromboembolism: examining some unanswered questions regarding location of treatment, product type, and dosing frequency. Arch Intern Med 2000; 160:181-8.
113. Pettila V, Leinonen P, Markkola A, Hiilesmaa V, Kaaja R. Postpartum bone mineral density in women treated for thromboprophylaxis with unfractionated heparin or LMW heparin. Thromb Haemost 2002; 87:182-6.
114. Malcolm JC, Keely EJ, Karovitch AJ, Wells PS. Use of low molecular weight heparin in acute venous thromboembolic events in pregnancy. J Obstet Gynaecol Can 2002; 24:568-71.
115. 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(5 Pt 1):1113-17.
116. Hunt BJ, Doughty HA, Majumdar G, et al. Thromboprophylaxis with low molecular weight heparin (Fragmin) in high risk pregnancies. Thromb Haemost 1997; 77:39-43.
117. Brieger D, Dawes J. Long-term persistence of biological activity following administration of Enoxaparin sodium (clexane) is due to sequestration of antithrombinbinding low molecular weight fragments-comparison with unfractionated heparin. Thromb Haemost 1996; 75(5):740-6.
118. Greer IA, Nelson-Piercy C. Low-molecular-weight heparins for thromboprophylaxis and treatment of venous thromboembolism in pregnancy: a systematic review of safety and efficacy. Blood 2005; 106:401-7.
119. Warkentin TE, Greinacher A. Heparin-induced thrombocytopenia: recognition, treatment, and prevention: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004; 126(3 Suppl):311S-37S.
120. Lepercq J, Conard J, Borel-Derlon A, et al. Venous thromboembolism during pregnancy: a retrospective study of enoxaparin safety in 624 pregnancies. BJOG 2001; 108:1134-40.
121. Huhle G, Geberth M, Hoffmann U, Heene DL, Harenberg J. Management of heparin-associated thrombocytopenia in pregnancy with subcutaneous r-hirudin. Gynecol Obstet Invest 2000; 49(1):67-69.
122. Payne SM, Kovacs MJ. Cutaneous dalteparin reactions associated with antibodies of heparin-induced thrombocytopenia. Ann Pharmacother 2003; 37(5):655-8.
123. Howell R, Fidler J, Letsky E, de Swiet M. The risks of antenatal subcutaneous heparin prophylaxis: a controlled trial. Br J Obstet Gynaecol 1983; 90(12):1124- 28.
124. Richter C, Sitzmann J, Lang P,Weitzel H, Huch A, Huch R. Excretion of low molecular weight heparin in human milk. Br J Clin Pharmacol 2001; 52:708-10.
125. Chan WS, Anand SS, Ginsberg JS. Anticoagulation of pregnant women with mechanical heart valves. Arch Intern Med 2000; 160:191-6.
126. Das SK, Cohen AT, Edmondson RA, Melissari E, Kakkar VV. Low-molecularweight heparin versus warfarin for prevention of recurrent venous thromboembolism: a randomized trial. World J Surg 1996; 20:521-6.
127. Lee AYY, Levine MN, Baker RI, et al. Low-molecular-weight Heparin versus a coumarin for the prevention of recurrent venous thromboembolism in patients with cancer. N Engl J Med 2003; 349:146-53.
128. Prandoni P, Lensing AW, Piccioli A, et al. Recurrent venous thromboembolism and bleeding complications during anticoagulant treatment in patients with cancer and venous thrombosis. Blood 2002; 100:3484-88.
129. Kearon C, Hirsh J. Management of anticoagulation before and after elective surgery. N Engl J Med 1997; 336:1506-11.
130. Turrentine MA, Braems G, Ramirez MM. Use of thrombolytics for the treatment of thromboembolic disease during pregnancy. Obstet Gynecol Surv 1995; 50(7):534-41.
131. Schindewolf M, Mosch G, Bauersachs RM, Lindhoff-Last E. Safe anticoagulation with danaparoid in pregnancy and lactation. Thromb Haemost 2004; 92(1):211.
132. Harrison SJ, Rafferty I, McColl MD. Management of heparin allergy during pregnancy with danaparoid. Blood Coagul Fibrinolysis 2001; 12:157-9.
133. Myers B,Westby J, Strong J. Prophylactic use of danaparoid in high-risk pregnancy with heparin-induced thrombocytopaenia-positive skin reaction. Blood Coagul Fibrinolysis 2003; 14:485-7.
134. Aijaz A, Nelson J, Naseer N. Management of heparin allergy in pregnancy. Am J Hematol 2001; 67(4):268-9.
135. Lagrange F, Vergnes C, Brun JL, et al. Absence of placental transfer of pentasaccharide (Fondaparinux, Arixtra) in the dually perfused human cotyledon in vitro. Thromb Haemost 2002; 87:831-5.
136. Lindqvist PG, Svensson PJ, Marsaal K, Grennert L, Luterkort M, Dahlback B. Activated protein C resistance (FV:Q506) and pregnancy. Thromb Haemost 1999; 81(4):532-7.
137. Gates S, Brocklehurst P, Ayers S, Bowler U. Thromboprophylaxis and pregnancy: two randomized controlled pilot trials that used low-molecular-weight heparin. Am J Obstet Gynecol 2004; 191:1296-1303.
138. Burrows RF, Gan ET, Gallus AS, Wallace EM, Burrows EA. A randomised doubleblind placebo controlled trial of low molecular weight heparin as prophylaxis in preventing venous thrombolic events after caesarean section: a pilot study. BJOG 2001; 108:835-9.
139. Gates S, Brocklehurst P, Davis LJ. Prophylaxis for venous thromboembolic disease in pregnancy and the early postnatal period (Cochrane Review). The Cochrane Library. Oxford: Update Software, 2002.
140. Royal College of Obstetricians and Gynaecologists. Report of the RCOG Working Party on Prophylaxis against Thromboembolism in Gynaecology and Obstetrics. London, The Royal College of Obstetricians and Gynaecologists, 1995.
141. Bates SM, Greer IA, Pabinger I, Sofaer S, Hirsh J. Venous thromboembolism, thrombophilia, antithrombotic therapy, and pregnancy: American College of Chest Physicians Evidence-based Clinical Practice Guidelines. (8th ed). Chest 2008; 133:844S-86S.
142. Rodger MA, Kahn SR, Cranney A, et al. Long-term dalteparin in pregnancy not associated with a decrease in bone mineral density: substudy of a randomized controlled trial. J Thromb Haemost 2007; 5:1600-6.
143. Rosendaal FR, Helmerhorst FM, Vandenbroucke JP. Oral contraceptives, hormone replacement therapy and thrombosis. Thromb Haemost 2001; 86:112-23.
144. Vandenbroucke JP, Koster T, Briet E, Reitsma PH, Bertina RM, Rosendaal FR. Increased risk of venous thrombosis in oral-contraceptive users who are carriers of factor V Leiden mutation. Lancet 1994; 344(8935):1453-7.
145. Simioni P, Sanson BJ, Prandoni P, et al. Incidence of venous thromboembolism in families with inherited thrombophilia. Thromb Haemost 1999; 81:198-202.
146. Hoibraaten E, Qvigstad E, Arnesen H, Larsen S, Wickstrom E, Sandset PM. Increased risk of recurrent venous thromboembolism during hormone replacement therapy. Results of the randomized, double-blind, placebo-controlled Estrogen in Venous Thromboembolism Trial (EVTET). Thromb Haemost 2000; 84(6):961-7.
147. Mismetti P, Laporte S, Darmon JY, Buchmuller A, Decousus H. Meta-analysis of low molecular weight heparin in the prevention of venous thromboembolism in general surgery. Br J Surg 2001; 88:913-930.
148. Bergqvist D, Eldor A, Thorlacius-Ussing O, Combe S, Cossec-Vion MJ. Efficacy and safety of enoxaparin versus unfractionated heparin for prevention of deep vein thrombosis in elective cancer surgery: a double-blind randomized multicentre trial with venographic assessment. Br J Surg 1997; 84:1099-1103.
149. Martel N, Wells PS. A Meta-analysis to determine the risk of heparin induced thrombocytopenia (HIT) and isolated thrombocytopenia in prophylaxis studies comparing unfractionated heparin (UFH) and low molecular weight heparin (LMWH). Blood 2004; 104:708a-709a.
150. Vongpatanasin W, Hillis LD, Lange RA. Prosthetic heart valves. N Engl J Med 1996; 335:407-16.
151. Salem DN, O'Gara PT, Madias C, Pauker SG. Valvular and structural heart disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 2008; 133(6 Suppl):593S-629S.
152. Kovacs MJ, Kearon C, Rodger MA, et al. Single-arm study of bridging therapy with low-molecular-weight heparin for patients at risk of arterial embolism who require temporary interruption of warfarin. Circulation 2004; 110:1658-63.
153. van Driel D, Wesseling J, Sauer PJ, Touwen BC, van d, V, Heymans HS. Teratogen update: fetal effects after in utero exposure to coumarins overview of cases, followup findings, and pathogenesis. Teratology 2002; 66:127-140.
154. Schaefer C, Hannemann D, Meister R, et al. Vitamin K antagonists and pregnancy outcome. A multi-centre prospective study. Thromb Haemost 2006; 95:949-57.
155. Oran B, Lee-Parritz A, Ansell J. Low molecular weight heparin for the prophylaxis of thromboembolism in women with prosthetic mechanical heart valves during pregnancy. Thromb Haemost 2004; 92:747-51.
156. Seshadri N, Goldhaber SZ, Elkayam U, et al. The clinical challenge of bridging anticoagulation with low-molecular-weight heparin in patients with mechanical prosthetic heart valves: an evidence-based comparative review focusing on anticoagulation options in pregnant and nonpregnant patients. Am Heart J 2005; 150:27-34.
157. CLASP (Collaborative Low-dose Aspirin Study in Pregnancy) Collaborative Group. CLASP: a randomised trial of low-dose aspirin for the prevention and treatment of pre-eclampsia among 9364 pregnant women. Lancet 1994; 343:619-29.