PMID- 11449342
OWN - NLM
STAT- MEDLINE
DCOM- 20011214
LR  - 20191105
IS  - 0037-1963 (Print)
IS  - 0037-1963 (Linking)
VI  - 38
IP  - 2 Suppl 5
DP  - 2001 Apr
TI  - Unexplored territories in the nonsurgical patient: a look at pregnancy.
PG  - 39-48
AB  - Venous thromboembolism (VTE) remains the most common cause of maternal death 
      during pregnancy and the puerperium. The risk is increased in women older than 35 
      years and those with obesity, previous VTE, operative delivery, and underlying 
      thrombophilia. Anticoagulant therapy is indicated for short-term treatment of VTE 
      and as thromboprophylaxis in high-risk patients. Warfarin is contraindicated 
      during the first trimester because of fetotoxicity; unfractionated heparin (UFH) 
      is associated with practical disadvantages and a risk of heparin-induced 
      thrombocytopoenia (HIT) and osteoporosis with long-term use. Low-molecular-weight 
      heparins (LMWHs) are convenient to use, do not cross the placenta, carry a lower 
      risk of HIT and osteoporosis, and have been shown to be safe and effective during 
      treatment of approximately 500 pregnant women. LMHWs are increasingly replacing 
      UFH as the anticoagulant of choice during pregnancy; further studies are required 
      to determine optimal therapeutic and thromboprophylactic doses. Women with 
      inherited or acquired thrombophilia are at increased risk of severe pregnancy 
      complications, including recurrent miscarriage, pre-eclampsia, fetal growth 
      restriction, abruptio placentae, and stillbirth; uteroplacental microvascular 
      thrombosis caused by thrombophilia appears to be the pathophysiologic link. LMWHs 
      have been shown to improve pregnancy outcome in women with a history of obstetric 
      complications and confirmed thrombophilia.
CI  - Copyright 2001 by W.B. Saunders Company.
FAU - Eldor, A
AU  - Eldor A
AD  - Tel-Aviv Sourasky Medical Center, The Sackler Faculty of Medicine, Tel-Aviv, 
      Israel.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Semin Hematol
JT  - Seminars in hematology
JID - 0404514
RN  - 0 (Anticoagulants)
SB  - IM
MH  - Anticoagulants/therapeutic use
MH  - Female
MH  - Humans
MH  - Pregnancy
MH  - Pregnancy Complications, Hematologic/*drug therapy/prevention & control
MH  - Thromboembolism/drug therapy/etiology/prevention & control
MH  - Thrombophilia/complications/*drug therapy/etiology
MH  - Venous Thrombosis/drug therapy/etiology/prevention & control
RF  - 61
EDAT- 2001/07/13 10:00
MHDA- 2002/01/05 10:01
CRDT- 2001/07/13 10:00
PHST- 2001/07/13 10:00 [pubmed]
PHST- 2002/01/05 10:01 [medline]
PHST- 2001/07/13 10:00 [entrez]
AID - ashem0380039 [pii]
AID - 10.1016/s0037-1963(01)90097-6 [doi]
PST - ppublish
SO  - Semin Hematol. 2001 Apr;38(2 Suppl 5):39-48. doi: 10.1016/s0037-1963(01)90097-6.