PMID- 29421832
OWN - NLM
STAT- MEDLINE
DCOM- 20191016
LR  - 20201209
IS  - 1098-8785 (Electronic)
IS  - 0735-1631 (Linking)
VI  - 35
IP  - 9
DP  - 2018 Jul
TI  - Heparin-Induced Thrombocytopenia during Obstetric Hospital Admissions.
PG  - 898-903
LID - 10.1055/s-0038-1627096 [doi]
AB  - INTRODUCTION: The rate of heparin-induced thrombocytopenia (HIT) on a population 
      basis is unknown. The objective of this study was to characterize the risk for 
      HIT during antepartum, delivery, and postpartum hospitalizations in the United 
      States. MATERIALS AND METHODS: A large administrative database was used to 
      determine the risk of HIT in hospitalized obstetric patients who received 
      unfractionated heparin (UFH) or low molecular weight heparin (LMWH). Patients 
      were presumed to have HIT if they were exposed to UFH or LMWH, received a 
      diagnosis of HIT, and were administered a medication for the treatment of HIT 
      including bivalirudin, argatroban, fondaparinux, or lepirudin. We queried severe 
      complications of HIT including arterial thrombosis, limb amputation, heart 
      failure, and death. RESULTS: We identified 66,468 antepartum hospitalizations, 
      66,741 delivery hospitalizations, and 16,325 postpartum readmissions where women 
      received pharmacologic prophylaxis. Of these, 10 antepartum admissions, 1 
      delivery admission, and 14 postpartum readmissions involved a diagnosis of HIT 
      with treatment of bivalirudin, argatroban, fondaparinux, or lepirudin. There were 
      no deaths and no diagnoses of arterial thrombosis, limb amputation, heart 
      failure, and death. CONCLUSION: Risk for HIT among hospitalized obstetric 
      patients is low. In this cohort, no cases of death or severe complications were 
      noted in relation to the diagnosis.
CI  - Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
FAU - Sagaram, Deepika
AU  - Sagaram D
AD  - Department of Obstetrics and Gynecology, College of Physicians and Surgeons, 
      Columbia University, New York, New York.
FAU - Siddiq, Zainab
AU  - Siddiq Z
AD  - Department of Obstetrics and Gynecology, College of Physicians and Surgeons, 
      Columbia University, New York, New York.
FAU - Eisenberger, Andrew B
AU  - Eisenberger AB
AD  - Division of Hematology/Oncology, Department of Medicine, College of Physicians 
      and Surgeons, Columbia University, New York, New York.
FAU - Ananth, Cande V
AU  - Ananth CV
AD  - Department of Obstetrics and Gynecology, College of Physicians and Surgeons, 
      Columbia University, New York, New York.
AD  - Department of Epidemiology, Joseph L. Mailman School of Public Health, Columbia 
      University, New York, New York.
FAU - Wright, Jason D
AU  - Wright JD
AD  - Department of Obstetrics and Gynecology, College of Physicians and Surgeons, 
      Columbia University, New York, New York.
FAU - D'Alton, Mary E
AU  - D'Alton ME
AD  - Department of Obstetrics and Gynecology, College of Physicians and Surgeons, 
      Columbia University, New York, New York.
FAU - Friedman, Alexander M
AU  - Friedman AM
AD  - Department of Obstetrics and Gynecology, College of Physicians and Surgeons, 
      Columbia University, New York, New York.
LA  - eng
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20180208
PL  - United States
TA  - Am J Perinatol
JT  - American journal of perinatology
JID - 8405212
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 0 (Hirudins)
RN  - 0 (Peptide Fragments)
RN  - 0 (Pipecolic Acids)
RN  - 0 (Recombinant Proteins)
RN  - 0 (Sulfonamides)
RN  - 9005-49-6 (Heparin)
RN  - 94ZLA3W45F (Arginine)
RN  - IY90U61Z3S (argatroban)
RN  - J177FOW5JL (Fondaparinux)
RN  - TN9BEX005G (bivalirudin)
RN  - Y43GF64R34 (lepirudin)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Arginine/analogs & derivatives
MH  - Databases, Factual
MH  - *Delivery, Obstetric
MH  - Female
MH  - Fondaparinux/adverse effects
MH  - Heparin/*adverse effects
MH  - Heparin, Low-Molecular-Weight/adverse effects
MH  - Hirudins/adverse effects
MH  - Hospitalization/*statistics & numerical data/trends
MH  - Humans
MH  - Middle Aged
MH  - Peptide Fragments/adverse effects
MH  - Pipecolic Acids/adverse effects
MH  - Postpartum Period
MH  - Pregnancy
MH  - Recombinant Proteins/adverse effects
MH  - Risk Assessment
MH  - Sulfonamides
MH  - Thrombocytopenia/*chemically induced/*epidemiology
MH  - United States/epidemiology
MH  - Young Adult
COIS- None.
EDAT- 2018/02/09 06:00
MHDA- 2019/10/17 06:00
CRDT- 2018/02/09 06:00
PHST- 2018/02/09 06:00 [pubmed]
PHST- 2019/10/17 06:00 [medline]
PHST- 2018/02/09 06:00 [entrez]
AID - 10.1055/s-0038-1627096 [doi]
PST - ppublish
SO  - Am J Perinatol. 2018 Jul;35(9):898-903. doi: 10.1055/s-0038-1627096. Epub 2018 
      Feb 8.