A survey of obstetricians indicates a preference for using prophylactic anticoagulants, specifically a warfarin-to-heparin regimen, in pregnant patients with a history of pulmonary embolism.
Survey preferences should not alter practice; leaves open optimal anticoagulation regimen for pregnant patients with prior PE.
SummaryThe views of 353 practising members of the Royal College of Obstetricians, ascertained by postal survey. indicate that the majority would use prophylactic anticoagulants in a patient who had had a previous pulmonary embolus in pregnancy. The most popular regimen is warfarin starting after 16 weeks maturity, changing to heparin a few weeks before term, reducing the dose 24 hours before labour. Oral anticoagulants would be continued for at least six weeks in the puerperium. The implications of this regimen are discussed.
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Swiet et al. (1980) studied this question.
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