PMID- 20229677
OWN - NLM
STAT- MEDLINE
DCOM- 20100420
LR  - 20190917
IS  - 0370-8179 (Print)
IS  - 0370-8179 (Linking)
VI  - 138 Suppl 1
DP  - 2010 Jan
TI  - Efficacy and safety of nadroparin and unfractionated heparin for the treatment of 
      venous thromboembolism during pregnancy and puerperium.
PG  - 18-22
AB  - INTRODUCTION: The optimal treatment of pregnancy associated VTE (venous 
      thromboembolism) has not been established yet. OBJECTIVE: The assessment of the 
      efficacy and safety of low molecular weight heparin (LMWH) nadroparin and 
      unfractionated heparin (UFH) used for the treatment of pregnancy and puerperium 
      related VTE. Primary study goals were to analyze the incidence of recurrent VTE 
      (proximal extension or pulmonary thromboembolism), thrombocytopenia, major and 
      minor hemorrhages and skin allergic reactions. The study also included the 
      incidence of miscarriages, stillbirth and neonatal abnormalities. We also studied 
      the relationship between the presence of thrombophilia and the occurrence of 
      complications during VTE treatment. METHODS: Seventy-two women with antepartal 
      VTE treated with s.c. LMWH during entire pregnancy and 88 women with postpartal 
      VTE initially treated with either s.c. LMWH or i.v.UFH were under follow-up 
      during the entire treatment. Thrombophilia testing included antithrombin, protein 
      C and protein S activity levels, Activated protein C (APC) resistance, LA, ACL, 
      FV Leiden, FII G20210A and MTHFR C677T mutations. RESULTS: Twice a day weight 
      based therapeutic regimen was applied for LMWH and activated partial 
      thromboplastin time (aPTT) adjusted UFH dosages. After 2-6 weeks of antepartal 
      deep vein thrombosis (DVT) treatment the dose of nadroparin was reduced to 
      intermediate level. The duration of LMWH therapy during pregnancy was 1-35 weeks, 
      on average 16 weeks. One case (0.62%) of DVT propagation into the vena cava 
      occurred in a woman with antithrombin deficiency treated with LMWH. Two women 
      (1.25%) had minor bleeding and 5 (3.125%) had minimal bleeding, while 3 (1.9%) 
      had skin allergic reactions. The rate of successful pregnancy outcome was 97.2%. 
      There were no cases of stillbirth or neonatal congenital abnormalities. 
      Thrombophilia was found in 86 women (53.7%). No statistically significant 
      correlation between the presence of thrombophilia and treatment complications 
      were found. CONCLUSION: Nadroparin is both safe and effective for the treatment 
      of DVT during pregnancy and puerperium.
FAU - Mitic, Gorana
AU  - Mitic G
AD  - Institute of Laboratory Medicine, Clinical Centre of Vojvodina, Novi Sad, Serbia. 
      miticgns@yahoo.com
FAU - Kovac, Mirjana
AU  - Kovac M
FAU - Povazan, Ljubica
AU  - Povazan L
FAU - Djordjevic, Valentina
AU  - Djordjevic V
FAU - Ilic, Vesna
AU  - Ilic V
FAU - Salatic, Iva
AU  - Salatic I
FAU - Lazic, Radmila
AU  - Lazic R
FAU - Antonijevic, Nebojsa
AU  - Antonijevic N
FAU - Novakov-Mikic, Aleksandra
AU  - Novakov-Mikic A
LA  - eng
PT  - Journal Article
PL  - Serbia
TA  - Srp Arh Celok Lek
JT  - Srpski arhiv za celokupno lekarstvo
JID - 0027440
RN  - 0 (Anticoagulants)
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Nadroparin)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Anticoagulants/adverse effects/*therapeutic use
MH  - Female
MH  - Fibrinolytic Agents/adverse effects/*therapeutic use
MH  - Heparin/adverse effects/*therapeutic use
MH  - Humans
MH  - Nadroparin/adverse effects/*therapeutic use
MH  - Pregnancy
MH  - Pregnancy Complications, Cardiovascular/*drug therapy
MH  - Puerperal Disorders/*drug therapy
MH  - Venous Thromboembolism/*drug therapy
EDAT- 2010/03/17 06:00
MHDA- 2010/04/21 06:00
CRDT- 2010/03/17 06:00
PHST- 2010/03/17 06:00 [entrez]
PHST- 2010/03/17 06:00 [pubmed]
PHST- 2010/04/21 06:00 [medline]
AID - 10.2298/sarh10s1018m [doi]
PST - ppublish
SO  - Srp Arh Celok Lek. 2010 Jan;138 Suppl 1:18-22. doi: 10.2298/sarh10s1018m.