Low molecular weight heparin for the management of venous thromboembolism in pregnancy

ABSTRACT

This study is aiming to evaluate the effect and dose of Anoxaparin given to pregnant women with acute venous thromboembolism. This Observational 'prospective' study was carried out at Bab-El Shaareyia university hospital-Cairo-Egypt and Maternity Hospital, Sabbah- Kuwait on 20 pregnant women aged 22-41 years, with acute venous thromboembolism verified by objective means. Patients were treated with Enoxaparin from diagnosis until delivery. Treatment was monitored with anti-activated factor xa [anti-xa] activity, and the dose was adjusted to achieve 0.5-l.0U/ml 2-3 hours post-injection. Non of the patients suffered recurrent venous thromboembolisn or major bleeding complications. In 9 of 13 women starting with conventional dose of Enoxaparin, dose escalation was necessary to reach target anti- xa activity. None of the 6 women who started with Enoxaparin required dose escalation. One women who started with 133iu/kg bd required dose reduction. Bioaccumulaton was not observed. This study suggests that Enoxaparin may be used for the treatment acute venous thromboembolism in pregnancy approximately 10-20% higher doses of Enoxaparin may he needed as compared with non-pregnant individuals