Key result
Dalteparin treatment for acute venous thromboembolism in pregnancy resulted in 0% recurrent VTE or major bleeding, though dose escalation was required in 9 of 13 women starting at 100 iu/kg bd.
Why the study?
Does dalteparin achieve target anti-Xa activity and safely treat acute venous thromboembolism in pregnant women?
Observational (n=20)
Yes
Does dalteparin achieve target anti-Xa activity and safely treat acute venous thromboembolism in pregnant women?
Pregnant women with acute venous thromboembolism treated with dalteparin may require 10-20% higher doses than non-pregnant individuals to achieve target anti-Xa levels, with no recurrent VTE or major bleeding observed.
Supports anti-Xa monitoring and dose escalation for dalteparin in pregnant VTE; leaves open need for larger prospective confirmation.
Objective To evaluate the effect and dose of dalteparin given to pregnant women with acute venous thromboembolism. Design An observational study of pregnant women in Norway. Setting Delivery and haematological departments in Norway. Population Twenty women, aged 22–41 years, with acute venous thromboembolism verified by objective means. Methods Patients were treated with dalteparin from diagnosis until delivery. Treatment was monitored with anti-activated factor Xa (anti-Xa) activity, and the dose was adjusted to achieve target 0.5–1.0 U/mL 2–3 hours post-injection. Main outcome measure Anti-Xa activity and side effects. Result None of the patients suffered recurrent venous thromboembolism or major bleeding complications. In 9 of 13 women starting with conventional dose of dalteparin (100 iu/kg bd), dose escalation was necessary to reach target anti-Xa activity. None of the six women who started with 105–118 iu/kg bd required dose escalation. One woman who started with 133 iu/kg bd required dose reduction. Bioaccumulation of dalteparin was not observed. Conclusion Our study suggests that dalteparin may be used for the treatment of acute venous thromboembolism in pregnancy. Approximately 10–20% higher doses of dalteparin may be needed as compared with non-pregnant individuals.
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Anne-Birgitte Jacobsen (2003) conducted an observational in acute venous thromboembolism in pregnancy (n=20). Dalteparin was evaluated on Anti-Xa activity and side effects (recurrent venous thromboembolism or major bleeding complications). Dalteparin treatment for acute venous thromboembolism in pregnancy resulted in 0% recurrent VTE or major bleeding, though dose escalation was required in 9 of 13 women starting at 100 iu/kg bd.
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