Introduction
Antithrombotic therapy during pregnancy is used for the treatment and prophylaxis
of venous thromboembolic disease, for the prevention and treatment of arterial embolism
associated with valvular heart disease and/or prosthetic heart valves, for the prevention
of fetal growth retardation and pregnancy loss in patients with antiphospholipid antibodies,
and in patients with pregnancy-induced hypertension. Since antithrombotic agents have
the potential to produce complications in both the mother and fetus, their use during
pregnancy raises concerns. Guidelines are difficult to establish because the evidence
upon which recommendations are based is derived primarily from poor-quality studies.
This chapter reviews the fetal and maternal effects of antithrombotic agents including
oral anticoagulants, unfractionated heparin, low molecular weight heparins (LMWH),
and aspirin, and provides recommendations for their use during pregnancy.