Massive subchorionic hematoma associated with enoxaparin.
BACKGROUND
The use of low-molecular-weight heparins is increasing for the prevention of thromboembolism in pregnancy. Subchorionic hematoma as a complication of anticoagulation therapy is rarely reported.


METHODS
A persistent, massive subchorionic hematoma was diagnosed in a pregnant patient with atrial fibrillation and mitral stenosis. Enoxaparin was administered to maintain her trough anti-Xa level 0.5 units/mL or higher. The patient's peak anti-Xa levels never exceeded 1.05 units/mL. The patient underwent cesarean delivery at 34 6/7 weeks of gestation for preterm premature rupture of membranes.


CONCLUSIONS
Subchorionic hematoma is a potentially serious complication that can occur in pregnant patients receiving enoxaparin for the prevention of thromboembolism.
Lee
Richard H
RH
Los Angeles County-University of Southern California Medical Center, Women's and Children's Hospital, Los Angeles, CA 90033, USA. richardl@usc.edu
Goodwin
T Murphy
TM
D000328:Adult; D000925:Anticoagulants / Q000009:adverse effects*; D001281:Atrial Fibrillation; D002585:Cesarean Section; D002823:Chorion; D017984:Enoxaparin / Q000009:adverse effects*; D065427:Factor Xa Inhibitors; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D005865:Gestational Age; D006350:Heart Valve Prosthesis; D006406:Hematoma / Q000139:chemically induced* / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D016239:MEDLINE; D008943:Mitral Valve; D008946:Mitral Valve Stenosis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000139:chemically induced*; D011256:Pregnancy Outcome; D013923:Thromboembolism / Q000517:prevention & control; D014463:Ultrasonography
D000925:Anticoagulants; D017984:Enoxaparin; D065427:Factor Xa Inhibitors