title: HEPTEST: a suitable method for monitoring heparin during pregnancy.
abstract: Methods of monitoring heparin in pregnancy are problematic. The aim of this study was to assess the plasma HEPTEST as a rapid and reliable test for heparin monitoring in pregnancy. HEPTEST, activated partial thromboplastin time (APTT) and chromogenic anti-Xa assays were performed on individual heparin-spiked plasma samples from two groups: normal non-pregnant women (n = 6) and normal pregnant women during the third trimester (n = 6). Heparin activity curves were established in plasma from both groups for low (< 0.3 IU/ml), intermediate (0.3-0.7 IU/ml) and high (> 0.7 IU/ml) heparin concentrations and validated by comparison with the anti-Xa chromogenic assay. Both the APTT and HEPTEST demonstrated good correlation with anti-Xa levels across all heparin concentrations in both plasma groups (r range = 0.879-0.945). In comparison with the APTT, the HEPTEST showed better correlation with anti-Xa levels at low concentrations of heparin (r values 0.933 vs. 0.772, respectively). For both the APTT and HEPTEST there were significant differences between the clotting times in pregnant and non-pregnant plasma at a number of heparin concentrations. This data supports the plasma HEPTEST as an acceptable alternative to the chromogenic anti-Xa assay for monitoring heparin thromboprophylaxis in pregnancy.
authors.affiliation: Department of Haematology, Central Middlesex Hospital, London, UK.
authors.forename: P J
authors.initials: PJ
authors.lastname: Campbell
authors.forename: M A
authors.initials: MA
authors.lastname: Tirvengadum
authors.forename: W
authors.initials: W
authors.lastname: Pickering
authors.forename: H
authors.initials: H
authors.lastname: Cohen
authors.forename: K E
authors.initials: KE
authors.lastname: Ryan
mesh_terms: D000328:Adult; D001681:Biological Assay; D005260:Female; D006493:Heparin / Q000097:blood*; D006801:Humans; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D011247:Pregnancy; D011263:Pregnancy Trimester, Third / Q000097:blood*
chemical_list: D006493:Heparin