A prospective trial showing the safety of adjusted-dose enoxaparin for thromboprophylaxis of pregnant women with mechanical prosthetic heart valves.
To determine whether dosage adjustment of enoxaparin during pregnancy, to maintain a peak anti-Xa of 1.0 to 1.2 U/mL, is safe for women with mechanical prosthetic heart valves (MPHV).



A prospective observational study.



This study was performed at Charlotte Maxeke Johannesburg Academic Hospital from 2007 to 2009.



Fifteen women with MPHVs.



Women were treated with enoxaparin with dosage adjustment to achieve a peak anti-Xa of 1.0 to 1.2 U/ mL.



Main outcomes measured were prosthetic valve thrombosis, bleeding, and maternal mortality.



There was no maternal mortality. None of the women developed valvular thrombosis during pregnancy. In all, 2 women developed epistaxis and another developed spotting per vaginum.



Our data show that enoxaparin may be administered safely during pregnancy to pregnant women with MPHV when there is dosage adjustment throughout pregnancy to maintain an anti-Xa of 1.0 to 1.2 U/mL.
Saeed
Chitsike Rufaro
CR
Department of Haematology, University of Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital and National Health Laboratory Service (NHLS), Johannesburg, South Africa. rufaro.chitsike@gmail.com
Jacobson
Barry Frank
BF
Pravin
Manga
M
Aziz
Rhemtula Haroun
RH
Serasheini
Moodley
M
Dominique
Toweel Gabrielle
TG
D000293:Adolescent; D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D017984:Enoxaparin / Q000627:therapeutic use*; D005260:Female; D006349:Heart Valve Diseases / Q000628:therapy; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control*; D055815:Young Adult
D000925:Anticoagulants; D017984:Enoxaparin