title: Safety and efficacy of low molecular weight heparin therapy during pregnancy: three year experience at a tertiary care center.
abstract: OBJECTIVE
  To evaluate safety and efficacy of low molecular weight heparin given for various indications during pregnancy.
  
  
  METHODS
  A detailed retrospective analysis of all the patients who received low molecular weight heparin (LMWH) for various indications over a period of 3 years (2010-2012) at a tertiary care hospital in Northern India was performed.
  
  
  RESULTS
  Fifty-five patients received LMWH over the period of 3 years, for various indications. Enoxaparin (1 mg/kg body weight OD/BD subcutaneously) was used. The indications were valvular heart disease with valve replacement, atrial fibrillation, or thrombus in 60 % patients; chronic deep vein thrombosis (DVT) in 7 % patients; thrombophilia in 9.1 % patients; recurrent pregnancy losses in 18 % patients; and DVT prophylaxis in 5.5 % patients. Abortion was seen in 7.2 % patients; fetal growth restriction in 10.9 % patients; and oligohydramnios, preeclampsia, gestational hypertension, placenta previa, abruptio placentae, and postpartum hemorrhage in 1.8 % patients. Stillbirth occurred in 3.6 % patients. No thromboembolic event was noted in any of the patients. None of the patients had any documented thrombocytopenia or clinical fracture.
  
  
  CONCLUSIONS
  Low molecular weight heparin can be used in pregnancy for various indications as an alternative to unfractionated heparin or warfarin as it is efficacious and safe.
authors.affiliation: Department of Obstetrics and Gynaecology, Maulana Azad Medical College and Associated Lok Nayak Hospital, MAMC Campus, Delhi Gate, New Delhi, 110002 India.
authors.forename: Nilanchali
authors.initials: N
authors.lastname: Singh
authors.affiliation: Department of Obstetrics and Gynaecology, Maulana Azad Medical College and Associated Lok Nayak Hospital, MAMC Campus, Delhi Gate, New Delhi, 110002 India.
authors.forename: Priya
authors.initials: P
authors.lastname: Varshney
authors.affiliation: Department of Obstetrics and Gynaecology, Maulana Azad Medical College and Associated Lok Nayak Hospital, MAMC Campus, Delhi Gate, New Delhi, 110002 India.
authors.forename: Reva
authors.initials: R
authors.lastname: Tripathi
authors.affiliation: Department of Obstetrics and Gynaecology, Maulana Azad Medical College and Associated Lok Nayak Hospital, MAMC Campus, Delhi Gate, New Delhi, 110002 India.
authors.forename: Y M
authors.initials: YM
authors.lastname: Mala
authors.affiliation: Department of Obstetrics and Gynaecology, Maulana Azad Medical College and Associated Lok Nayak Hospital, MAMC Campus, Delhi Gate, New Delhi, 110002 India.
authors.forename: Shakun
authors.initials: S
authors.lastname: Tyagi
keywords: Heart disease; Low molecular weight heparin; Pregnancy; Safety; Thrombophilias