title: A systematic review on the use of new anticoagulants in pregnancy.
abstract: New anticoagulants such as direct factor Xa inhibitors and direct thrombin inhibitors have been recently developed, but their experience in pregnancy is limited. This review therefore aims to systematically search for studies on the use of these newer anticoagulants in pregnancy and the puerperal period. Searches were performed on electronic databases MEDLINE (from 1966), EMBASE (from 1974) and the Cochrane Library, until October 2011 using terms of 'pregnancy', 'puerperium', 'breastfeeding' and names of specific anticoagulants. The search yielded 561 citations and 11 studies (10 on fondaparinux, 1 on ximelagatran) were included. Newer anticoagulants (fondaparinux, hirudin and argatroban) on the limited evidence appear not to have adverse pregnancy outcomes, but there is currently no experience of new oral anticoagulants (rivaroxaban, apixaban, betrixaban or dabigatran) use in pregnancy. There is a need for reporting on new oral anticoagulation use in pregnancy to provide more information about the safety and risks to the fetusin utero.
authors.affiliation: Fetal Medicine Unit, Liverpool Women's NHS Foundation Trust, Crown Street, Liverpool L8 7SS, UK.
authors.forename: Ai-Wei
authors.initials: AW
authors.lastname: Tang
authors.affiliation: Faculty of Health & Life Sciences, University of Liverpool, Foundation Building, Liverpool L69 7ZX, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: Greer
keywords: anticoagulants; direct factor Xa inhibitors; direct thrombin inhibitors; pregnancy