Low molecular weight heparin (dalteparin) for the treatment of venous thromboembolism in pregnancy.

Abstract

OBJECTIVE:

To evaluate the effect and dose of dalteparin given to pregnant women with acute venous thromboembolism.

DESIGN:

An observational study of pregnant women in Norway.

SETTING:

Delivery and haematological departments in Norway.

POPULATION:

Twenty women, aged 22-41 years, with acute venous thromboembolism verified by objective means.

METHODS:

Patients were treated with dalteparin from diagnosis until delivery. Treatment was monitored with anti-activated factor Xa (anti-Xa) activity, and the dose was adjusted to achieve target 0.5-1.0 U/mL 2-3 hours post-injection.

MAIN OUTCOME MEASURES:

Anti-Xa activity and side effects.

RESULT:

None of the patients suffered recurrent venous thromboembolism or major bleeding complications. In 9 of 13 women starting with conventional dose of dalteparin (100 iu/kg bd), dose escalation was necessary to reach target anti-Xa activity. None of the six women who started with 105-118 iu/kg bd required dose escalation. One woman who started with 133 iu/kg bd required dose reduction. Bioaccumulation of dalteparin was not observed.

CONCLUSION:

Our study suggests that dalteparin may be used for the treatment of acute venous thromboembolism in pregnancy. Approximately 10-20% higher doses of dalteparin may be needed as compared with non-pregnant individuals.

• Authors: Anne Flem Jacobsen, Erik Qvigstad, Per Morten Sandset
• Journal: BJOG : an international journal of obstetrics and gynaecology (BJOG) Vol. 110 Issue 2 Pg. 139-44 (Feb 2003) ISSN: 1470-0328 [Print] England
• PMID: 12618157 (Publication Type: Evaluation Study, Journal Article, Multicenter Study)

Chemical References

• Anticoagulants
• Factor Xa
• Dalteparin

Topics

• Acute Disease
• Adult
• Anticoagulants (administration & dosage)
• Dalteparin (administration & dosage)
• Factor Xa (metabolism)
• Female
• Humans
• Norway
• Pregnancy
• Pregnancy Complications, Cardiovascular (drug therapy)
• Pregnancy Outcome
• Thromboembolism (drug therapy)
• Treatment Outcome