The safety of low molecular weight heparin therapy during labor
Objective: Current recommendations are to discontinue low molecular weight heparin (LMWH) at least 24 hours prior to labor induction or administering epidural anesthesia. We assessed the safety of discontinuing LMWH 12-24 hours before delivery. Methods: We evaluated the prevalence of hemorrhagic com...
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Published in | The journal of maternal-fetal & neonatal medicine Vol. 17; no. 1; pp. 39 - 43 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
England
Informa UK Ltd
01.01.2005
Taylor & Francis Taylor & Francis Ltd |
Subjects | |
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Abstract | Objective: Current recommendations are to discontinue low molecular weight heparin (LMWH) at least 24 hours prior to labor induction or administering epidural anesthesia. We assessed the safety of discontinuing LMWH 12-24 hours before delivery.
Methods: We evaluated the prevalence of hemorrhagic complications during labor, cesarean or epidural catheter placement in 284 women treated with enoxaparin during pregnancy as compared with 16132 untreated women. Treated participants were divided into subgroups by the various intervals between last LMWH dose hemorrhage-prone events (vaginal delivery, epidural, cesarean etc.). The rate of hemorrhagic complications and hemoglobin values were compared between the study and control groups.
Results: Postpartum hemorrhage was uncommon and occurred in 2.1% and 1.9% in study and control groups, respectively (p = 0.13). Antenatal as well as postnatal hemoglobin values were very similar for treated and untreated women. No differences were noted between women who discontinued enoxaprin 12-24 hours before labor and those who discontinued treatment later with regard to maternal hemorrhagic complications. No spinal hematomas were report among 12792 treated and un-treated women who had epidural or spinal block. No hemorrhagic neonatal complications were encountered.
Conclusion: Discontinuing LMWH more than 12 hours before delivery is safe in relation to maternal hemorrhagic complications. |
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AbstractList | Objective: Current recommendations are to discontinue low molecular weight heparin (LMWH) at least 24 hours prior to labor induction or administering epidural anesthesia. We assessed the safety of discontinuing LMWH 12-24 hours before delivery.
Methods: We evaluated the prevalence of hemorrhagic complications during labor, cesarean or epidural catheter placement in 284 women treated with enoxaparin during pregnancy as compared with 16132 untreated women. Treated participants were divided into subgroups by the various intervals between last LMWH dose hemorrhage-prone events (vaginal delivery, epidural, cesarean etc.). The rate of hemorrhagic complications and hemoglobin values were compared between the study and control groups.
Results: Postpartum hemorrhage was uncommon and occurred in 2.1% and 1.9% in study and control groups, respectively (p = 0.13). Antenatal as well as postnatal hemoglobin values were very similar for treated and untreated women. No differences were noted between women who discontinued enoxaprin 12-24 hours before labor and those who discontinued treatment later with regard to maternal hemorrhagic complications. No spinal hematomas were report among 12792 treated and un-treated women who had epidural or spinal block. No hemorrhagic neonatal complications were encountered.
Conclusion: Discontinuing LMWH more than 12 hours before delivery is safe in relation to maternal hemorrhagic complications. Current recommendations are to discontinue low molecular weight heparin (LMWH) at least 24 hours prior to labor induction or administering epidural anesthesia. We assessed the safety of discontinuing LMWH 12-24 hours before delivery. We evaluated the prevalence of hemorrhagic complications during labor, cesarean or epidural catheter placement in 284 women treated with enoxaparin during pregnancy as compared with 16132 untreated women. Treated participants were divided into subgroups by the various intervals between last LMWH dose hemorrhage-prone events (vaginal delivery,epidural, cesarean etc.). The rate of hemorrhagic complications and hemoglobin values were compared between the study and control groups. Postpartum hemorrhage was uncommon and occurred in 2.1% and 1.9% in study and control groups, respectively (p=0.13). Antenatal as well as postnatal hemoglobin values were very similar for treated and untreated women. No differences were noted between women who discontinued enoxaprin 12-24 hours before labor and those who discontinued treatment later with regard to maternal hemorrhagic complications. No spinal hematomas were report among 12792 treated and un-treated women who had epidural or spinal block. No hemorrhagic neonatal complications were encountered. Discontinuing LMWH more than 12 hours before delivery is safe in relation to maternal hemorrhagic complications. OBJECTIVE: Current recommendations are to discontinue low molecular weight heparin (LMWH) at least 24 hours prior to labor induction or administering epidural anesthesia. We assessed the safety of discontinuing LMWH 12-24 hours before delivery. METHODS: We evaluated the prevalence of hemorrhagic complications during labor, cesarean or epidural catheter placement in 284 women treated with enoxaparin during pregnancy as compared with 16132 untreated women. Treated participants were divided into subgroups by the various intervals between last LMWH dose hemorrhage-prone events (vaginal delivery,epidural, cesarean etc.). The rate of hemorrhagic complications and hemoglobin values were compared between the study and control groups. RESULTS: Postpartum hemorrhage was uncommon and occurred in 2.1% and 1.9% in study and control groups, respectively (p=0.13). Antenatal as well as postnatal hemoglobin values were very similar for treated and untreated women. No differences were noted between women who discontinued enoxaprin 12-24 hours before labor and those who discontinued treatment later with regard to maternal hemorrhagic complications. No spinal hematomas were report among 12792 treated and un-treated women who had epidural or spinal block. No hemorrhagic neonatal complications were encountered. CONCLUSION: Discontinuing LMWH more than 12 hours before delivery is safe in relation to maternal hemorrhagic complications. |
Author | Maslovitz, Sharon Lessing, Joseph B Varon, David Kupferminc, Michael J Landsberg, Jessica Ascher Many, Ariel |
Author_xml | – sequence: 1 givenname: Sharon surname: Maslovitz fullname: Maslovitz, Sharon email: orshma@hotmail.co.il organization: 1Department of Obstetrics and Gynecology, Lis Maternity Hospital, Aviv Sourasky Medical Center, Tel-Aviv, Israel – sequence: 2 givenname: Ariel surname: Many fullname: Many, Ariel email: orshma@hotmail.co.il organization: 1Department of Obstetrics and Gynecology, Lis Maternity Hospital, Aviv Sourasky Medical Center, Tel-Aviv, Israel – sequence: 3 givenname: Jessica Ascher surname: Landsberg fullname: Landsberg, Jessica Ascher email: orshma@hotmail.co.il organization: 1Department of Obstetrics and Gynecology, Lis Maternity Hospital, Aviv Sourasky Medical Center, Tel-Aviv, Israel – sequence: 4 givenname: David surname: Varon fullname: Varon, David email: orshma@hotmail.co.il organization: 1Department of Obstetrics and Gynecology, Lis Maternity Hospital, Aviv Sourasky Medical Center, Tel-Aviv, Israel – sequence: 5 givenname: Joseph B surname: Lessing fullname: Lessing, Joseph B email: orshma@hotmail.co.il organization: 1Department of Obstetrics and Gynecology, Lis Maternity Hospital, Aviv Sourasky Medical Center, Tel-Aviv, Israel – sequence: 6 givenname: Michael J surname: Kupferminc fullname: Kupferminc, Michael J email: orshma@hotmail.co.il organization: 1Department of Obstetrics and Gynecology, Lis Maternity Hospital, Aviv Sourasky Medical Center, Tel-Aviv, Israel |
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Snippet | Objective: Current recommendations are to discontinue low molecular weight heparin (LMWH) at least 24 hours prior to labor induction or administering epidural... Current recommendations are to discontinue low molecular weight heparin (LMWH) at least 24 hours prior to labor induction or administering epidural anesthesia.... OBJECTIVE: Current recommendations are to discontinue low molecular weight heparin (LMWH) at least 24 hours prior to labor induction or administering epidural... |
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SubjectTerms | Adult Anticoagulants - administration & dosage Anticoagulants - adverse effects Drug Administration Schedule Enoxaparin Enoxaparine Female Hemoglobins - metabolism Hemorrhage - chemically induced Hemorrhage - epidemiology Heparin, Low-Molecular-Weight - administration & dosage Heparin, Low-Molecular-Weight - adverse effects Humans Infant, Newborn Infant, Newborn, Diseases - chemically induced Infant, Newborn, Diseases - epidemiology labor Labor, Obstetric Pregnancy Puerperal Disorders - chemically induced Puerperal Disorders - epidemiology safety |
Title | The safety of low molecular weight heparin therapy during labor |
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