PMID- 30818404
OWN - NLM
STAT- MEDLINE
DCOM- 20200831
LR  - 20200831
IS  - 1098-8785 (Electronic)
IS  - 0735-1631 (Linking)
VI  - 37
IP  - 3
DP  - 2020 Feb
TI  - Comparison of Continuation of Low-Molecular-Weight Heparin versus Switching to 
      Unfractionated Heparin in the Peripartum.
PG  - 304-312
LID - 10.1055/s-0039-1678667 [doi]
AB  - OBJECTIVE: This study aimed to determine whether switching from 
      low-molecular-weight heparin (LMWH) to unfractionated heparin (UFH) or its 
      continuation in the peripartum affected anesthesia choice or bleeding 
      complications. STUDY DESIGN: A retrospective cohort study of 189 anticoagulated 
      pregnant women who delivered at the University of Illinois at Chicago Hospital 
      and Health Science System from 2005 to 2016. Demography, anesthesia choice, and 
      bleeding complications were compared between the two groups. RESULTS: There were 
      138 (73%) women on LMWH versus 51 (27%) who switched from LMWH to UFH during the 
      peripartum. The demographics were similar, 123 women were on prophylactic: 81 
      (66%) were on LMWH and 42 (34%) switched to UFH. Of the 66 women on therapeutic 
      anticoagulation, 57 (86%) continued on LMWH, while 9 (14%) switched to UFH. No 
      difference in neuraxial anesthesia type received: 42 (82.4%) versus 108 (79.7%) 
      women (odds ratio: 1.20, 95% confidence interval [CI]: 0.52-2.73, p = 0.837). 
      Bleeding complications more than 1,000 mL, 6 versus 10% (relative risk [RR]: 
      0.58, 95% CI: 0.17-1.94, p = 0.380) and relaparotomy due to hemoperitoneum, 2% in 
      either group (RR: 0.9, 95% CI: 0.10-8.48, p = 0.930) were similar in the two 
      groups regardless of time of last injection. CONCLUSION: Anesthesia type and rate 
      of bleeding complications were similar between women on LMWH and UFH during the 
      peripartum.
CI  - Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
FAU - Enakpene, Christopher A
AU  - Enakpene CA
AD  - Division of Maternal-Fetal Medicine, Texas Tech University Health Sciences 
      Center, Permian Basin, Odessa, Texas.
AD  - Division of Maternal Fetal Medicine, University of Illinois at Chicago, Chicago, 
      Illinois.
FAU - Pontarelli, Kristina N
AU  - Pontarelli KN
AD  - Department of Obstetrics and Gynecology, University of Illinois at Chicago, 
      Chicago, Illinois.
FAU - Della Torre, Micaela
AU  - Della Torre M
AD  - Division of Maternal Fetal Medicine, University of Illinois at Chicago, Chicago, 
      Illinois.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20190228
PL  - United States
TA  - Am J Perinatol
JT  - American journal of perinatology
JID - 8405212
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Adult
MH  - Anesthesia, General
MH  - *Anesthesia, Obstetrical
MH  - Anticoagulants/*therapeutic use
MH  - Female
MH  - Heparin/adverse effects/*therapeutic use
MH  - Heparin, Low-Molecular-Weight/adverse effects/*therapeutic use
MH  - Humans
MH  - Peripartum Period
MH  - Postpartum Hemorrhage/*chemically induced/epidemiology
MH  - Pregnancy
MH  - Pregnancy Complications, Hematologic/*drug therapy/prevention & control
MH  - Retrospective Studies
MH  - Venous Thromboembolism/*drug therapy/prevention & control
COIS- None declared.
EDAT- 2019/03/01 06:00
MHDA- 2020/09/01 06:00
CRDT- 2019/03/01 06:00
PHST- 2019/03/01 06:00 [pubmed]
PHST- 2020/09/01 06:00 [medline]
PHST- 2019/03/01 06:00 [entrez]
AID - 10.1055/s-0039-1678667 [doi]
PST - ppublish
SO  - Am J Perinatol. 2020 Feb;37(3):304-312. doi: 10.1055/s-0039-1678667. Epub 2019 
      Feb 28.