March 24, 2003Archives of Internal Medicine
Anticoagulation of Pregnant Women With Mechanical Heart Valves
Why the study?
Is enoxaparin safe and effective for anticoagulation in pregnant women with mechanical heart valves compared to unfractionated heparin or warfarin?
Population
Pregnant women with mechanical heart valves
Comparison
Enoxaparin (low-molecular-weight heparin) vs Unfractionated heparin and warfarin
Design
Editorial
Authors
Discussion
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Overview
Unsupported warnings may restrict LMWH options in high-risk pregnancies; leaves open the need for dedicated trials and expert consensus on anticoagulation.
Structured PICO
Is enoxaparin safe and effective for anticoagulation in pregnant women with mechanical heart valves compared to unfractionated heparin or warfarin?
P
Population
Pregnant women with mechanical heart valves
I
Intervention
Enoxaparin (low-molecular-weight heparin)
C
Comparator
Unfractionated heparin and warfarin
O
Outcome
Treatment failures (including death from thrombosed valves) and teratogenicitysafety
This editorial highlights the clinical dilemma created by unsupported pharmaceutical warnings against enoxaparin use in pregnant women with mechanical heart valves, calling for expert consensus and rigorous studies.
Cite This Study
Ginsberg et al. (2003) studied this question.