Pearls in clinical obstetrics: challenges in anticoagulation in pregnancy.

Pearls in clinical obstetrics: challenges in anticoagulation in pregnancy.
Minerva Ginecol. 2018 Oct 24;:
Authors: Della Torre M, Digiovanni LM, Sutherland MB
Abstract
Women are at increased risk for VTE during both pregnancy and in the post-partum period. We have conducted a comprehensive literature review of the use of anticoagulation in pregnancy for pregnant women at increased risk for venous thromboembolism (VTE). Multiple factors, including physiologic and pharmacokinetic changes make the treatment and prevention of VTE complicated in pregnancy. Adequate treatment and prevention of VTE in pregnancy is critically important, yet good quality medical studies continue to be lacking. There is a growing amount of data for the use of LMWH in pregnant women and this remains the treatment of choice in most indications. For both prophylactic and therapeutic treatments, when LMWHs are chosen, monitoring of anti-factor Xa level, although controversial, is advised. Women with prosthetic valve who become pregnant face challenges in regard of type of anticoagulation, dosing and monitoring during pregnancy. Delivery options and peripartum care should be defined with a multidisciplinary approach and taking patient's preference and autonomy in consideration. More high-quality research on this topic is needed to guide the clinical care of this unique population.
PMID: 30360601 [PubMed - as supplied by publisher]

Source: Minerva Ginecologica - October 27, 2018 Category: OBGYN Tags: Minerva Ginecol Source Type: research