title: Safety of therapeutic doses of tinzaparin during pregnancy.
abstract: OBJECTIVE
  Low molecular weight heparin is recommended for the treatment of venous thromboembolism (VTE) during pregnancy. However, there are few reliable data regarding the safety of therapeutic doses of tinzaparin in this setting. The objective of this study was to assess the safety of once-daily therapeutic doses of tinzaparin for the treatment of VTE during pregnancy.
  
  
  METHODS
  A retrospective study was carried out in 3 tertiary care centres in France, from 1998 to 2009, including consecutive pregnant women who received once-daily therapeutic doses of tinzaparin (175 IU/kg/day).
  
  
  RESULTS
  We analyzed 87 pregnancies in 83 women, representing a total of 13,320 patient-days of treatment. Live-birth rate was 97.8%, with one case of miscarriage (<20 weeks of gestation) and one case of intrauterine foetal death (≥20 weeks). There was no antenatal major bleeding. Major bleeding occurred in 4 women during an emergency caesarean section. No case of heparin-induced thrombocytopenia and no maternal death were reported. There was no neonatal haemorrhage and no case of congenital abnormality. VTE recurred on treatment in one patient and after treatment interruption for several days in 2 other patients.
  
  
  CONCLUSIONS
  These results support the safety of once-daily tinzaparin at therapeutic dose for the treatment of VTE during pregnancy.
authors.affiliation: Université Paris-Sud, Faculté de Médecine, Service de Pneumologie et Réanimation Respiratoire, Hôpital Bicêtre, AP-HP, Le Kremlin Bicêtre and Institut National de la Santé et de la Recherche Médicale (INSERM) U999, Lille, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Parent
authors.forename: Philippe
authors.initials: P
authors.lastname: Deruelle
authors.forename: Olivier
authors.initials: O
authors.lastname: Sanchez
authors.forename: Guy
authors.initials: G
authors.lastname: Meyer
authors.forename: Philippe
authors.initials: P
authors.lastname: Girard
authors.forename: Fadia
authors.initials: F
authors.lastname: Jilwan
authors.forename: Catherine
authors.initials: C
authors.lastname: Boyer-Neumann
authors.forename: Martine
authors.initials: M
authors.lastname: Wolf
authors.forename: Gerald
authors.initials: G
authors.lastname: Simonneau
mesh_terms: D000328:Adult; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy*; D011256:Pregnancy Outcome; D000078222:Tinzaparin; D054556:Venous Thromboembolism / Q000188:drug therapy*
chemical_list: D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D000078222:Tinzaparin