Key result
Anticoagulant therapy with low molecular weight heparin or unfractionated heparin is effective and safe for treating pregnancy-related venous thromboembolism, with most bleeding complications occurring during the first week of treatment.
Why the study?
Venous thromboembolism contributes to maternal mortality, and evidence regarding the efficacy of low molecular weight heparin and unfractionated heparin remains limited.
What are the rates of recurrent VTE and bleeding associated with LMWH or UFH treatment in pregnant women with acute VTE?
What are the rates of recurrent VTE and bleeding associated with LMWH or UFH treatment in pregnant women with acute VTE?
Answers are grounded in this paper and cite their sources.
In pregnant women with acute VTE, treatment with LMWH or UFH is associated with a low rate of recurrent VTE but notable rates of peri and post-delivery bleeding.
Introduction: Venous thromboembolism (VTE) is a known factor implicated in maternal mortality. Low molecular weight heparin (LMWH) and unfractionated heparin (UFH) are being widely used in cases of VTE. However, the efficiency of both of these drugs in the treatment of VTE is limited. Hence, a scoping review was conducted to understand the role of these drugs in the case of VTE. Methodology: The studies that included either the VTE or pulmonary embolism (PE) or both, and the studies that used the intervention of either the LMWH or UHF or both were selected. Case-control or cohort studies were included. The studies that were case-reports or with a sample of <10 were excluded. Results: Fifteen studies included 819 subjects with acute VTE. A total of 506 deep venous thrombosis (DVTs) and 127 PEs were reported in these studies. A total of 656 individuals received LMWH and 150 received UFH. There were 21 cases of antenatal bleeding and 259 cases of peri and post-delivery bleeding. UFH was given intravenously and subcutaneously in accordance with activated partial thromboplastin time results. Fifteen recurrent VTEs: four were DVTs and 11 were PEs (one death).
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Ndjapa-Ndamkou et al. (2022) conducted a review in Venous thromboembolism in pregnancy (n=819). Anticoagulant therapy (LMWH and UFH) was evaluated on Recurrent VTE and bleeding events. Anticoagulant therapy with low molecular weight heparin or unfractionated heparin is effective and safe for treating pregnancy-related venous thromboembolism, with most bleeding complications occurring during the first week of treatment.
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