title: Successful use of danaparoid in treatment of heparin-induced thrombocytopenia during twin pregnancy.
abstract: BACKGROUND
  The treatment of heparin-induced thrombocytopenia in pregnancy is uncertain. Warfarin is contraindicated and ancrod is of unknown safety. Low-molecular-weight heparin should not be used because of cross-reactivity with unfractionated heparin. We report a case of heparin-induced thrombocytopenia during pregnancy treated successfully with danaparoid.
  
  
  METHODS
  A 25-year-old woman pregnant with twins developed heparin-induced thrombocytopenia after starting heparin therapy for a deep vein thrombosis. Treatment was initiated with danaparoid by subcutaneous injection and was continued until the time of delivery. Treatment was completed with 6 weeks of warfarin therapy postpartum. No fetal or maternal ill effects were observed.
  
  
  CONCLUSIONS
  Danaparoid, which has low cross-reactivity for heparin-dependent antibodies and no known fetopathic effects, was used successfully to treat our patient, who developed heparin-induced thrombocytopenia during pregnancy. Danaparoid may be the treatment of choice for this difficult clinical situation in which there are limited therapeutic options.
authors.affiliation: Department of Medicine, University of Western Ontario, London, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Gill
authors.forename: M J
authors.initials: MJ
authors.lastname: Kovacs
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D002809:Chondroitin Sulfates / Q000627:therapeutic use*; D003871:Dermatan Sulfate / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D006493:Heparin / Q000009:adverse effects* / Q000627:therapeutic use; D006496:Heparinoids / Q000627:therapeutic use*; D006497:Heparan Sulfate / Q000627:therapeutic use*; D006801:Humans; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy*; D011272:Pregnancy, Multiple / Q000097:blood*; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000188:drug therapy*; D014427:Twins; D020246:Venous Thrombosis / Q000188:drug therapy*
chemical_list: D000925:Anticoagulants; D002809:Chondroitin Sulfates; D003871:Dermatan Sulfate; D004338:Drug Combinations; D006493:Heparin; D006496:Heparinoids; D006497:Heparan Sulfate; C035838:danaparoid