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Anticoagulation in pregnancy and the puerperium

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dc.contributor.authorHague, W.
dc.contributor.authorNorth, R.
dc.contributor.authorGallus, A.
dc.contributor.authorWalters, B.
dc.contributor.authorOrlikowski, C.
dc.contributor.authorBurrows, R.
dc.contributor.authorCincotta, R.
dc.contributor.authorDekker, G.
dc.contributor.authorHiggins, J.
dc.contributor.authorLowe, S.
dc.contributor.authorMorris, J.
dc.contributor.authorPeek, M.
dc.date.issued2001
dc.descriptionCopyright © 2001 Australasian Medical Publishing
dc.description.abstractFor the management of acute thrombotic events in pregnancy therapeutic doses of low molecular weight heparins (LMWH) may be used, unless the shorter half-life of intravenous unfractionated heparin (UH) and predictable reversibility by protamine are important. Treatment should be continued up until delivery and into the puerperium. Pregnant women who have had an acute thrombotic event should be delivered by a specialist team. In the case of recent thrombosis, delivery should be planned and the time during which anticoagulation therapy is ceased around the time of delivery should be minimised. Therapeutic doses of LMWH contraindicate the use of regional anaesthesia, and a switch to intravenous UH before delivery may allow greater flexibility in this regard. Prophylactic doses of LMWH can be used to reduce the risk of recurrent thromboembolic events in pregnancy. The regimen used will depend on the previous history, the family history and the presence of risk factors, including the genetic and acquired causes of thrombophilia. Women with mechanical heart valves are at high risk during pregnancy and require therapeutic anticoagulation throughout pregnancy under the direction of experienced specialists. Low-dose aspirin can reduce the risk of recurrent pre-eclampsia by about 15%, but the role of UH and LMWH in the prevention of recurrent miscarriage or obstetric complications associated with uteroplacental insufficiency is still uncertain.
dc.description.statementofresponsibilityA Working Group on behalf of the Obstetric Medicine Group of Australasia
dc.identifier.citationMedical Journal of Australia, 2001; 175(5):258-263
dc.identifier.doi10.5694/j.1326-5377.2001.tb143561.x
dc.identifier.issn0025-729X
dc.identifier.issn1326-5377
dc.identifier.orcidHague, W. [0000-0002-5355-2955]
dc.identifier.orcidDekker, G. [0000-0002-7362-6683]
dc.identifier.urihttp://hdl.handle.net/2440/8370
dc.language.isoen
dc.publisherAustralasian Med Publ Co Ltd
dc.source.urihttp://www.mja.com.au/public/issues/175_05_030901/omga/omga.html
dc.subjectWorking Group of the Obstetric Medicine Group of Australasia
dc.subjectHumans
dc.subjectPregnancy Complications, Hematologic
dc.subjectVenous Thrombosis
dc.subjectHeparin, Low-Molecular-Weight
dc.subjectAnticoagulants
dc.subjectPrenatal Care
dc.subjectAnesthesia, Obstetrical
dc.subjectRisk Factors
dc.subjectPostpartum Period
dc.subjectPregnancy
dc.subjectFemale
dc.subjectPractice Guidelines as Topic
dc.titleAnticoagulation in pregnancy and the puerperium
dc.typeJournal article
pubs.publication-statusPublished

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