Preeclampsia prevention strategies. Pharmacokinetics and pharmacodynamics of low-molecular-weight heparin (LMWH) in pregnancy

2020 ◽  
Vol 2 (28) ◽  
pp. 18
Author(s):  
Natalia Turcan ◽  
Roxana Bohâlțea ◽  
Ducu Ioniţă ◽  
Alexandru Baroş ◽  
Eugen Radu ◽  
...  
Author(s):  
Ian A. Greer

Venous thromboembolism (VTE) is a leading cause of maternal mortality and morbidity. Prophylaxis and management of VTE in pregnancy can impact mortality and morbidity. The overall reported incidence of gestational VTE ranges from 0.5 to 2.2 per 1000 maternities with a relative 5–10-fold increase in risk during pregnancy, increasing to a daily risk of 15–35-fold in the puerperium, compared with non-pregnant women of similar age. Risk factors inform the use of thromboprophylaxis usually with low-molecular-weight heparin, which has a better safety profile than unfractionated heparin. VTE can occur at any time in pregnancy, but over 50% of events occur prior to 20 weeks’ gestation. As clinical diagnosis is unreliable, objective assessment is required when there is clinical suspicion of an event. Less than 10% of clinically suspected cases of VTE are confirmed on objective testing. Compression duplex ultrasonography is the first-line investigation for suspected gestational deep venous thrombosis and thoracic imaging with ventilation–perfusion scanning is required for suspected pulmonary embolism. Low-molecular-weight heparin is usually the first choice treatment for gestational VTE based on safety and efficacy.


2003 ◽  
Vol 101 (6) ◽  
pp. 1307-1311 ◽  
Author(s):  
V. Sephton ◽  
R. G. Farquharson ◽  
J. Topping ◽  
S. M. Quenby ◽  
C. Cowan ◽  
...  

Author(s):  
Mei Peng ◽  
Jian Huang ◽  
Yiling Ding

Background: Hypertriglyceridemia in pregnancy is a rare but well-known cause of hypertriglyceridemia-induced acute pancreatitis (HTGP) in pregnancy, a life-threatening condition that lacks an established guideline for treatment management. Case presentation: We report a case with a successful treatment management of hypertriglyceridemia in pregnancy. A pregnant woman had been with hypertriglyceridemia for more than seven years and a history of pregnancy termination due to the development of HTGP. Eleven months after her last pregnancy termination, the woman was pregnant again and she started managing her elevated levels of lipids in the second trimester throughout the pregnancy, with low molecular weight heparin and then combined with metformin, to prevent thrombosis. Results: The entire pregnancy progressed smoothly, and the triglycerides' level fluctuated during the second and the third trimester of pregnancy with a range of 16.15 to 47.65 mmol/L. A full-term delivery, with a reasonable outcome for both mother and newborn, was obtained. Compared with her last pregnancy, the outcomes of recent pregnancy were better off. Conclusion: Low molecular weight heparin combined with metformin can avoid maternal hypertriglyceridemia-induced pancreatitis in this single case. To our knowledge, such a combination of treatment management of patients with hypertriglyceridemia in pregnancy to prevent acute pancreatitis has not been reported previously.


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