title: Low molecular weight heparin (dalteparin) for the treatment of venous thromboembolism in pregnancy.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynaecology, Ullevål University Hospital, Oslo, Norway.
authors.forename: Anne Flem
authors.initials: AF
authors.lastname: Jacobsen
authors.forename: Erik
authors.initials: E
authors.lastname: Qvigstad
authors.forename: Per Morten
authors.initials: PM
authors.lastname: Sandset
mesh_terms: 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
chemical_list: D000925:Anticoagulants; D015951:Factor Xa; D017985:Dalteparin