ABSTRACT
BACKGROUND: Venous thromboembolism (VTE) during pregnancy and puerperium remains a major cause of maternal morbidity and mortality. The use of low molecular weight heparin (LMWH) constitutes a promising alternative for the prevention of VTE instead of unfractionated heparin as it can be administered subcutaneously once daily and without coagulation measurement. Unfortunately, the safety of LMWHs administration for the mother and fetus has not been well established. STUDY DESIGN: In order to examine the safety of enoxaparin to the fetus, 24 women were recruited and 40 mg of enoxaparin was administered in 14 of them. All 24 women were going to have an early termination of pregnancy due to major fetal malformations. Maternal blood samples were drawn before and after the injection of enoxaparin, while fetal blood samples were taken only after the drug administration. Anti-IIa and anti-Xa activities were measured. RESULTS: A statistically significant increase of anti-Xa activity in the mothers studied was pointed out, while there was no detection of anti-IIa and anti-Xa activities in the fetuses. CONCLUSIONS: Since no anti-IIa and anti-Xa activities were detected in the fetuses' blood samples, it is concluded that enoxaparin does not cross the placenta and therefore appears safe for the fetus.
Subject(s)
Enoxaparin/blood , Heparin, Low-Molecular-Weight/blood , Maternal-Fetal Exchange , Adolescent , Adult , Anticoagulants/administration & dosage , Anticoagulants/blood , Anticoagulants/toxicity , Antithrombin III/drug effects , Blood Coagulation Factors/drug effects , Blood Coagulation Tests , Consumer Product Safety , Drug Evaluation , Enoxaparin/administration & dosage , Enoxaparin/toxicity , Female , Fetal Blood , Fetus/blood supply , Fetus/drug effects , Heparin, Low-Molecular-Weight/administration & dosage , Heparin, Low-Molecular-Weight/toxicity , Humans , Middle Aged , PregnancyABSTRACT
An 18-year old woman with type I Gaucher disease and two uncomplicated pregnancies is described. Although she experienced one miscarriage and pregnancy was associated with exaggeration of the clinical symptoms, leading to the diagnosis of the disorder, both her 2nd and 3rd pregnancies were uneventful and deterioration of her clinical situation was not observed. The issue of criteria for risk assessment in pregnancy of type I Gaucher disease patients is addressed.
Subject(s)
Gaucher Disease/complications , Pregnancy Complications , Abortion, Spontaneous/etiology , Adolescent , Female , Gaucher Disease/diagnosis , Humans , Pregnancy , Pregnancy Complications/diagnosis , Pregnancy Outcome , Risk FactorsABSTRACT
Immunoreactive human Chorionic Gonadotropin (hCG) was measured in serum and urine extracts from patients with malignant disease using a radioimmunoassay that detects efficiently hCG and its betasubunit. Of the 70 patients examined, 12 (17.1%) were positive for hCG in serum and 31 44.3%) in urine. Eleven patients who were positive in serum were also positive in urine; 20 patients (28.6%) were positive only in urine. Sephadex G-100 chromatography of urine from two serum-negative and urine-positive patients showed that the hCG immunoreactive material in the urine of these patients was mostly a molecular species smaller than hCG and hCG-beta. The nature of this molecule(s) is unknown and is called here metabolite(s) "X" of hCG-beta. The urine of 2 patients who where positive for hCG in both serum and urine contained considerable amount of metabolite(s) "X" as well as the native hCG-beta subunit, which was present also in the serum of these 2 patients. The metabolite(s) "X" was also shown by chromatography in the urine of a pregnant woman. It is concluded that the ectopic production of hCG is found more than twice as frequently in urine as compared to when serum alone is examined. The urine of serum-negative tumor patients can be positive for hCG because of the presence in it of the metabolite(s) "X" of hCG-beta or hCG which presumably circulates in the blood of these patients at non-detectable levels.
