Key result
Low-molecular-weight heparins and unfractionated heparin are safe and efficacious during pregnancy, whereas warfarin should be avoided except in the highest-risk situations.
Low-molecular-weight heparins and unfractionated heparin are safe and efficacious during pregnancy when properly managed, whereas warfarin should be avoided except in the highest-risk situations such as mechanical heart valves.
Supports heparin preference over warfarin in pregnancy; leaves open optimal regimens for thrombophilias and mechanical valves.
Prescribing anticoagulants to pregnant women can be difficult and stressful. Fortunately, low-molecular-weight heparins (LMWHs) and unfractionated heparin are quite safe and efficacious when properly selected, dosed, and monitored. Maternal and fetal concerns must be considered at all times, with a careful assessment of the risks and benefits of anticoagulant therapy in each patient. Further research should help to clarify who should receive thromboprophylaxis, how to prevent adverse pregnancy outcomes in women with various thrombophilias, and how best to treat pregnant women who have a prosthetic heart valve.
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Gibson et al. (2009) conducted a review in Pregnancy requiring anticoagulation. Anticoagulants (LMWH, unfractionated heparin, warfarin) was evaluated. Low-molecular-weight heparins and unfractionated heparin are safe and efficacious during pregnancy, whereas warfarin should be avoided except in the highest-risk situations.
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