دورية أكاديمية
أعرض في EDS

The risk of postpartum hemorrhage in women using high dose of low-molecular-weight heparins during pregnancy.

التفاصيل البيبلوغرافية
العنوان: The risk of postpartum hemorrhage in women using high dose of low-molecular-weight heparins during pregnancy.
المؤلفون: Knol HM; Division of Haemostasis and Thrombosis, Department of Haematology, University Medical Centre Groningen, The Netherlands. h.m.knol@og.umcg.nl, Schultinge L, Veeger NJ, Kluin-Nelemans HC, Erwich JJ, Meijer K
المصدر: Thrombosis research [Thromb Res] 2012 Sep; Vol. 130 (3), pp. 334-8. Date of Electronic Publication: 2012 Apr 03.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Pergamon Press Country of Publication: United States NLM ID: 0326377 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-2472 (Electronic) Linking ISSN: 00493848 NLM ISO Abbreviation: Thromb Res Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Elmsford, N. Y., Pergamon Press.
مواضيع طبية MeSH: Drug-Related Side Effects and Adverse Reactions/*epidemiology , Heparin, Low-Molecular-Weight/*administration & dosage , Postpartum Hemorrhage/*epidemiology , Pregnancy Complications, Cardiovascular/*epidemiology , Pregnancy Complications, Cardiovascular/*prevention & control , Venous Thromboembolism/*epidemiology , Venous Thromboembolism/*prevention & control, Adult ; Comorbidity ; Female ; Humans ; Incidence ; Netherlands/epidemiology ; Pregnancy ; Retrospective Studies ; Risk Factors ; Women
مستخلص: Background: Low-molecular-weight heparins (LMWH) are the most commonly used anticoagulant during pregnancy for prevention or treatment of VTE. However, the size of the associated risk of postpartum haemorrhage (PPH) is unknown.
Objective: To assess the bleeding risk of high dose LMWH, also in relation to time between last dose LMWH and delivery.
Material and Methods: From 1999 to 2009, we followed 88 pregnant women who were started on therapeutic anticoagulation. Controls were pregnant women without LMWH, matched 1:4 for parity, mode of delivery, age, gestational age and delivery date. PPH was defined as >500 ml blood loss for vaginal delivery (severe PPH in vaginal delivery as >1000 ml) and >1000 ml for cesarean section (CS). Women were divided into subgroups by the interval between last dose of anticoagulation and delivery (<12, 12-24 hrs, >24 hrs).
Results: Risk of PPH after vaginal delivery was 30% and 18% for LMWH-users and non-users, respectively (OR 1.9, 95%CI 1.1-3.5). Risk of severe PPH after vaginal delivery was not different (5.6 vs 5.0%; OR 1.1; 0.4-3.6). Risk of PPH after CS was 12% in LMWH-users and 4% in non-users (OR 2.9; 0.5-19.4). Both events of LMWH-users occurred after emergency CS. The risk of PPH associated with delivery within 24 hours after last dose of LMWH was 1.2 fold higher (95%CI 0.4-3.6) compared to a larger interval.
Conclusion: High dose LMWH carries an increased risk of more than 500 mL blood loss after vaginal delivery. However, this results not in more clinical relevant severe PPHs. The interval between last dose of LMWH and delivery does not influence the risk of PPH.
(Copyright © 2012 Elsevier Ltd. All rights reserved.)
المشرفين على المادة: 0 (Heparin, Low-Molecular-Weight)
تواريخ الأحداث: Date Created: 20120406 Date Completed: 20130131 Latest Revision: 20131121
رمز التحديث: 20240628
DOI: 10.1016/j.thromres.2012.03.007
PMID: 22475315
قاعدة البيانات: MEDLINE
الوصف
تدمد:1879-2472
DOI:10.1016/j.thromres.2012.03.007