Low-Molecular-Weight Heparin May Not Prevent Thrombosis

Low-dose heparin in women at high risk of pregnancy-related VTE leads to treatment failure

THURSDAY, Feb. 10 (HealthDay News) - Low-dose low-molecular-weight-heparin (LMWH) does not effectively prevent venous thromboembolism (VTE) in high-risk pregnant women, according to a study published online Jan. 13 in the Journal of Thrombosis and Haemostasis.

Jeanine E. Roeters van Lennep, M.D., Ph.D., of Erasmus Medical Center in Rotterdam, Netherlands, and colleagues evaluated the safety and effectiveness of a prophylactic protocol of low-dose LMWH in pregnant women at intermediate to high risk of VTE. The retrospective study analyzed 34 women with intermediate risk of VTE who received low-dose LMWH six weeks postpartum and 57 women with high risk of VTE who received low-dose LMWH during pregnancy and six weeks postpartum. Effectiveness was evaluated by incidence of pregnancy-related VTE and safety as incidence of postpartum hemorrhage (PPH).

The researchers found an incidence of pregnancy-related VTE of 5.5 percent, despite prophylaxis with low-dose LMWH. All the events occurred in women at high risk of VTE, with a postpartum incidence of 7 percent, and an antepartum incidence of 1.8 percent. The risk of PPH was 21.6 percent and severe PPH 9.1 percent, regardless of whether the women were started on LMWH during pregnancy or postpartum.

"VTE prophylaxis with low-dose LMWH in women at high risk of pregnancy-related VTE leads to considerable treatment failure. Although current guidelines support the use of low-dose LMWH during pregnancy and postpartum as VTE prophylaxis in pregnant women, this dose might not be sufficient," the authors write.

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