Prophylaxis and treatment of thromboembolic diseases during pregnancy with dalteparin.
OBJECTIVE
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.


METHODS
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.
Rey
E
E
Department of Obstetrics and Gynecology, Saint Justine Hospital, Quebec, Montreal, Canada. evelyne-rey@ssss.gouv.qc.ca
Rivard
G E
GE
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D015992:Body Mass Index; D001835:Body Weight; D017985:Dalteparin / Q000627:therapeutic use*; D016903:Drug Monitoring; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007279:Injections, Subcutaneous; D019476:Insect Proteins; D010976:Platelet Count; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood / Q000188:drug therapy* / Q000517:prevention & control*; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D012471:Salivary Proteins and Peptides / Q000097:blood*; D013923:Thromboembolism / Q000097:blood / Q000188:drug therapy* / Q000517:prevention & control*; D015430:Weight Gain
D000925:Anticoagulants; D019476:Insect Proteins; D012471:Salivary Proteins and Peptides; C114100:anticoagulant factor Xa protein, Aedes aegypti; D017985:Dalteparin