title: Use of fondaparinux in a pregnant woman with pulmonary embolism and heparin-induced thrombocytopenia.
abstract: BACKGROUND
  A serious complication of heparin treatment, heparin-induced thrombocytopenia (HIT) is rarely observed in pregnant women. Drug therapy during pregnancy should always be chosen to minimize fetal risk. The management of HIT in pregnancy represents a medical challenge. Unlike heparins, the anticoagulants used in patients with HIT do cross the placenta, with unknown fetal effects.
  
  
  METHODS
  We present a case of a 24-year-old female presenting for care at 34 weeks of gestation with acute pulmonary embolism treated initially with unfractionated heparin (UFH) and low molecular weight heparin (LMWH), who developed HIT. She was then successfully treated with fondaparinux.
  
  
  CONCLUSIONS
  To the best of our knowledge, this is one of the first case reports describing a successful use of fondaparinux in the treatment of HIT in a third-trimester pregnant woman, providing a novel approach for this subset of patients.
authors.affiliation: Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland. michal.ciurzynski@wum.edu.pl
authors.forename: Michał
authors.initials: M
authors.lastname: Ciurzyński
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Jankowski
authors.forename: Bronisława
authors.initials: B
authors.lastname: Pietrzak
authors.forename: Natalia
authors.initials: N
authors.lastname: Mazanowska
authors.forename: Ewa
authors.initials: E
authors.lastname: Rzewuska
authors.forename: Robert
authors.initials: R
authors.lastname: Kowalik
authors.forename: Piotr
authors.initials: P
authors.lastname: Pruszczyk
mesh_terms: D005260:Female; D000077425:Fondaparinux; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D011134:Polysaccharides / Q000008:administration & dosage / Q000627:therapeutic use*; D011247:Pregnancy; D011655:Pulmonary Embolism / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000150:complications / Q000188:drug therapy*; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D011134:Polysaccharides; D006493:Heparin; D000077425:Fondaparinux