title: A prospective trial showing the safety of adjusted-dose enoxaparin for thromboprophylaxis of pregnant women with mechanical prosthetic heart valves.
abstract: 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.
authors.affiliation: Department of Haematology, University of Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital and National Health Laboratory Service (NHLS), Johannesburg, South Africa. rufaro.chitsike@gmail.com
authors.forename: Chitsike Rufaro
authors.initials: CR
authors.lastname: Saeed
authors.forename: Barry Frank
authors.initials: BF
authors.lastname: Jacobson
authors.forename: Manga
authors.initials: M
authors.lastname: Pravin
authors.forename: Rhemtula Haroun
authors.initials: RH
authors.lastname: Aziz
authors.forename: Moodley
authors.initials: M
authors.lastname: Serasheini
authors.forename: Toweel Gabrielle
authors.initials: TG
authors.lastname: Dominique
mesh_terms: 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
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin