Tinzaparin safety and efficacy in pregnancy.
BACKGROUND
Unfractionated heparin has largely been replaced by low molecular weight heparin in the treatment and prevention of thrombosis and recurrent miscarriage in pregnancy. There is little information, however, about the efficacy and safety of tinzaparin, which has the advantage of being administered as a single daily dose.


OBJECTIVE
To evaluate the safety and efficacy of tinzaparin use in pregnancy.


METHODS
We retrospectively reviewed the medical records of women who were prescribed tinzaparin during pregnancy and the puerperium in our hospitals from January 2000 to December 2008. Tinzaparin was given as a single daily prophylactic dose for women with a history of venous thromboembolism (VTE) or recurrent miscarriage and as a single daily therapeutic dose for women diagnosed with VTE. The primary outcomes recorded were thrombosis, bleeding, allergy and thrombocytopenia.


RESULTS
One hundred and forty-nine women aged between 17 and 44 years received tinzaparin in pregnancy and the puerperium over the study period. The dose administered was therapeutic in 21 (14 %) cases and prophylactic in all others. VTE recurred in three women who had a history of VTE (3.6 %). Antepartum and postpartum haemorrhage occurred in 9.7 and 5 % of cases, respectively and two women developed thrombocytopenia but their platelets remained above 100,000/ml. Fifty-seven women (38 %) had regional anaesthesia without complication.


CONCLUSIONS
Our study demonstrates a safety profile for tinzaparin in pregnancy that is equivalent to other low molecular weight heparins with the advantage of single daily dosing.
Lankenau Medical Center, Wynnewood, PA, USA, khalifeha@mlhs.org.
A
A
Khalifeh
J
J
Grantham
J
J
Byrne
K
K
Murphy
F
F
McAuliffe
B
B
Byrne
D000026:Abortion, Habitual / Q000188:drug therapy*; D000293:Adolescent; D000328:Adult; D004342:Drug Hypersensitivity / Q000209:etiology; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006470:Hemorrhage / Q000139:chemically induced; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D006473:Postpartum Hemorrhage / Q000139:chemically induced; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000139:chemically induced / Q000517:prevention & control*; D011655:Pulmonary Embolism / Q000188:drug therapy; D012189:Retrospective Studies; D013921:Thrombocytopenia / Q000139:chemically induced; D013927:Thrombosis / Q000139:chemically induced; D000078222:Tinzaparin; D014592:Uterine Hemorrhage / Q000139:chemically induced; D054556:Venous Thromboembolism / Q000517:prevention & control*; D055815:Young Adult
D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D000078222:Tinzaparin