Low molecular weight heparin (dalteparin) for the treatment of venous thromboembolism in pregnancy.
OBJECTIVE
To evaluate the effect and dose of dalteparin given to pregnant women with acute venous thromboembolism.


METHODS
An observational study of pregnant women in Norway.


METHODS
Delivery and haematological departments in Norway.


METHODS
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.


METHODS
Anti-Xa activity and side effects.


RESULTS
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.


CONCLUSIONS
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.
Jacobsen
Anne Flem
AF
Department of Obstetrics and Gynaecology, Ullevål University Hospital, Oslo, Norway.
Qvigstad
Erik
E
Sandset
Per Morten
PM
D000208:Acute Disease; D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage*; D017985:Dalteparin / Q000008:administration & dosage*; D015951:Factor Xa / Q000378:metabolism; D005260:Female; D006801:Humans; D009664:Norway; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy*; D011256:Pregnancy Outcome; D013923:Thromboembolism / Q000188:drug therapy*; D016896:Treatment Outcome
D000925:Anticoagulants; D015951:Factor Xa; D017985:Dalteparin