The efficacy of low molecular weight heparin in the prevention of thromboembolic disease in pregnant patients with mechanical prosthetic heart valves.
Date
2012-01-11
Authors
Chitsike, Rufaro Saeed
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Abstract
Objective: To determine whether dosage adjustment of enoxaparin during pregnancy, in order to
maintain a peak anti-Xa of 1.0-1.2 U/ml, is safe for women with mechanical prosthetic heart
valves (MPHV).
Methods: This was a prospective observational study performed at Charlotte Maxeke
Johannesburg Academic Hospital from 2007 to 2009. 15 women with MPHVs were treated with
enoxaparin with dosage adjustment throughout pregnancy to achieve a peak anti-Xa of 1.0-1.2
U/ml. Main outcomes measured were prosthetic valve thrombosis, bleeding and maternal
mortality.
Results: There was no maternal mortality. None of the women developed valvular thrombosis
during pregnancy. Two women developed epistaxis and another developed spotting per vagina.
There was no foetal mortality.
Conclusion: Our data show that enoxaparin may be administered safely during pregnancy to
pregnant women with mechanical prosthetic heart valves when there is dosage adjustment
throughout pregnancy in order to maintain an anti-Xa of 1.0-1.2 U/ml.