Heparin levels to guide thromboembolism prophylaxis during pregnancy

American Journal of Obstetrics and Gynecology
L A BarbourR A Marlar

Abstract

Our purpose was to determine the dose of heparin required in pregnant women to achieve the same heparin levels as standard doses of 5000 units given subcutaneously every 12 hours in the nonpregnant population. Fourteen pregnant women placed on heparin prophylaxis for a history of thromboembolism had blood drawn for 64 anti-Xa level determinations in the second and third trimesters. Heparin doses were adjusted in an attempt to achieve a midinterval or peak level of 0.05 to 0.25 U/ml, which corresponds to the range seen in nonpregnant patients given standard doses of 5000 units subcutaneously every 12 hours. A standard heparin dose of 5000 units given subcutaneously every 12 hours was inadequate to achieve the desired range in this pregnant population. In five of nine second-trimester pregnancies 7500 units given subcutaneously every 12 hours was inadequate to attain this range. In six of 13 third-trimester pregnancies, > 10,000 units subcutaneously every 12 hours was needed. Heparin requirements may increase and are highly variable in patients during pregnancy. Until appropriate clinical outcomes trials can determine optimal dosing, measuring anti-Xa activity may be useful to guide therapy.

References

Dec 1, 1992·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·S GillisA Eldor
Oct 1, 1992·Chest·J S Ginsberg, J Hirsh
Mar 1, 1990·British Journal of Obstetrics and Gynaecology·T DahlmanM Hellgren
Feb 9, 1974·British Medical Journal·M A Badaracco, M P Vessey
Dec 1, 1983·British Journal of Obstetrics and Gynaecology·M de SwietP H Wise
Jan 1, 1983·Acta Obstetricia Et Gynecologica Scandinavica·A BergqvistT Hallböök

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Citations

Nov 11, 2009·Journal of Thrombosis and Thrombolysis·Wendy Lim
Oct 25, 2000·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·E Rey, G E Rivard
Jul 3, 1999·European Journal of Obstetrics, Gynecology, and Reproductive Biology·F RobinR Taurelle
Mar 28, 1998·Neurologic Clinics·J GilmoreB J Stern
Sep 22, 1998·Clinical Obstetrics and Gynecology·H L Brown, R A Bobrowski
Feb 24, 2001·Clinical Obstetrics and Gynecology·M S Esplin
Jul 17, 1999·Current Opinion in Pulmonary Medicine·K A Valentine
Oct 11, 2005·Critical Care Medicine·Sarah E Stone, Timothy A Morris
Nov 4, 2006·Clinical Obstetrics and Gynecology·Holly L Casele
Dec 20, 2005·Obstetrical & Gynecological Survey·Andra H JamesLeo R Brancazio
Aug 14, 2010·International Journal of Rheumatic Diseases·Hiroshi OgishimaTakayuki Sumida
Jun 23, 2007·BMJ : British Medical Journal·Wendy LimJeffrey S Ginsberg
Nov 18, 2003·Reproductive Biology and Endocrinology : RB&E·Michael J Kupferminc
Apr 6, 2007·International Heart Journal·Tetsuya SatoToru Hioka
Sep 12, 2000·Current Cardiology Reports·T G DeLoughery
Jun 7, 2011·International Journal of Obstetric Anesthesia·H BoyceG M Stocks
Sep 1, 1997·Obstetrics and Gynecology Clinics of North America·L A Barbour
Jan 22, 2002·Best Practice & Research. Clinical Obstetrics & Gynaecology·P S Gibson, K Rosene-Montella
Nov 16, 1999·American Journal of Obstetrics and Gynecology·H L CaseleR Venkataramanan
Nov 16, 1999·American Journal of Obstetrics and Gynecology·A G WitlinB M Sibai
Mar 8, 2003·Hematology·Caroline R Shiach
Sep 12, 2006·Obstetrics and Gynecology Clinics of North America·Stephan Danik, Valentin Fuster
Sep 8, 2004·Journal of the Society for Gynecologic Investigation·Mary H H Ensom, Mary D Stephenson
Dec 28, 2017·Obstetrical & Gynecological Survey·Eric LuThomas G DeLoughery
Apr 2, 2013·The Cochrane Database of Systematic Reviews·Hatoko SasakiRintaro Mori
Jun 26, 2018·Obstetrics and Gynecology·UNKNOWN American College of Obstetricians and Gynecologists' Committee on Practice Bulletins—Obstetrics
Aug 5, 2004·Obstetrics and Gynecology·Siobhan QuenbyGill Vince
Oct 6, 2000·Postgraduate Medicine·J S Sellman, R L Holman
Jan 1, 1997·Obstetrical & Gynecological Survey·M R Toglia, T E Nolan
Nov 14, 2020·American Journal of Reproductive Immunology : AJRI·Ae Ra HanSung Ki Lee
Sep 25, 2004·Critical Care Clinics·Sarah E Stone, Timothy A Morris
Aug 22, 2001·Obstetrics and Gynecology Clinics of North America·R L Andres, A Miles

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