Guidelines for Use of Anticoagulation in Pregnancy

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Key points

  • For acute thrombosis or thrombosis prophylaxis in pregnancy, use low-molecular-weight heparin (LMWH) as first-line therapy unless contraindicated.

  • Follow pregnant patients on therapeutic LMWH with anti–factor Xa levels (target level of 0.6–1 unit/mL 4 hours after dose) every 1 to 3 months. Patients on prophylactic LMWH do not require monitoring unless they have a body mass index greater than 40 or have renal disease.

  • Patients with lupus anticoagulant on unfractionated heparin (UFH), or any

Conclusion

The recommendations above are based on the current guidelines for anticoagulation in pregnancy for patients with an acute thromboembolism or thromboembolism prevention. These recommendations may also be applicable for patients that require anticoagulant therapy in pregnancy for other reasons, see articles by Lockshin, Odibo and Stout, and Paidas and Hossain elsewhere in this issue.

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