Why the study?
Does dalteparin at prophylactic or therapeutic doses maintain adequate anti-Xa activity levels throughout pregnancy?
Does dalteparin at prophylactic or therapeutic doses maintain adequate anti-Xa activity levels throughout pregnancy?
Standard prophylactic and weight-adjusted therapeutic doses of dalteparin maintain adequate anti-Xa levels throughout pregnancy without requiring third-trimester dose modifications for most women.
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Supports adequate anti-Xa levels with standard dalteparin dosing in pregnancy; leaves open need for randomized confirmation before changing monitoring.
OBJECTIVES: To determine if a prophylactic dose of dalteparin, 5000 IU daily, and if the adjusted-weight dalteparin therapeutic dose of 100 IU/kg twice daily are appropriate in pregnancy. METHOD: Anti-Xa activity levels were used to assess prophylactic (33 women) and therapeutic (15 women) dalteparin dosage throughout pregnancy. Analysis of variance was used and P-values less than 0.05 were considered statistically significant. RESULTS: In the prophylactic group, anti-Xa activity levels did not vary significantly throughout pregnancy (P=0.15). The initial dalteparin dose was modified on the first anti-Xa activity measurement in eight women, whose weight was statistically different from those remaining on the initial dose (P<0.001). The adjusted-weight therapeutic dalteparin dose induced adequate anti-Xa activity levels. CONCLUSIONS: Dalteparin, 5000 IU daily, is suitable for most pregnant women and does not need to be modified in the third trimester. A therapeutic dalteparin dose adjusted according to pregnancy weight is appropriate.
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Rey et al. (2000) studied this question.
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