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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

Bernd-Jan Sanson
1   From the Department of Vascular Medicine and The Netherlands
,
Anthonie W. A. Lensing
1   From the Department of Vascular Medicine and The Netherlands
,
Martin H. Prins
2   Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, Amsterdam, The Netherlands
,
Jeffrey S. Ginsberg
3   Department of Medicine, McMaster University, Hamilton, Ontario, Canada
,
Zinoviy S. Barkagan
4   Siberian Regional Center on Thrombosis and Hemostasis, Altai Medical University, Barnaul, Russia
,
Edith Lavenne-Pardonge
5   Department of Hemostasis, Catholic University of Louvain, Brussels, Belgium
,
Benjamin Brenner
6   Thrombosis and Hemostasis Unit, Rambam Medical Center, Haifa, Israel
,
Mordechay Dulitzky
7   Department of Gynecology and Obstetrics, Sheba Medical Center, Tel Aviv, Israel
,
Jørn D. Nielsen
8   Coagulation Laboratory and Thrombosis Center, Gentofte Hospital, Hellerup, Denmark
,
Zoltan Boda
9   2nd Department of Medicine, University of Debrecen, Hungary
,
Susanna Turi
10   Department of Gynecology and Obstetrics, I. Haynal University School of Health Sciences, Budapest, Hungary
,
Melvin R. Mac Gillavry
11   Department of Internal Medicine, Slotervaart Hospital, Amsterdam, The Netherlands
,
Karly Hamulyák
12   Department of Internal Medicine, University Hospital of Maastricht, The Netherlands
,
Ingrid M. Theunissen
5   Department of Hemostasis, Catholic University of Louvain, Brussels, Belgium
,
Beverley J. Hunt
13   The Rayne Institute, St Thomas’ Hospital, London, The United Kingdom
,
Harry R. Büller
1   From the Department of Vascular Medicine and The Netherlands
› Author Affiliations
Further Information

Publication History

Received 17 December 1998

Accepted after revision 08 February 1999

Publication Date:
09 December 2017 (online)

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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.

 

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