Singh Nilanchali, Varshney Priya, Tripathi Reva, Mala Y M, Tyagi Shakun
Department of Obstetrics and Gynaecology, Maulana Azad Medical College and Associated Lok Nayak Hospital, MAMC Campus, Delhi Gate, New Delhi, 110002 India.
J Obstet Gynaecol India. 2013 Dec;63(6):373-7. doi: 10.1007/s13224-013-0412-4. Epub 2013 Jun 12.
To evaluate safety and efficacy of low molecular weight heparin given for various indications during pregnancy.
A detailed retrospective analysis of all the patients who received low molecular weight heparin (LMWH) for various indications over a period of 3 years (2010-2012) at a tertiary care hospital in Northern India was performed.
Fifty-five patients received LMWH over the period of 3 years, for various indications. Enoxaparin (1 mg/kg body weight OD/BD subcutaneously) was used. The indications were valvular heart disease with valve replacement, atrial fibrillation, or thrombus in 60 % patients; chronic deep vein thrombosis (DVT) in 7 % patients; thrombophilia in 9.1 % patients; recurrent pregnancy losses in 18 % patients; and DVT prophylaxis in 5.5 % patients. Abortion was seen in 7.2 % patients; fetal growth restriction in 10.9 % patients; and oligohydramnios, preeclampsia, gestational hypertension, placenta previa, abruptio placentae, and postpartum hemorrhage in 1.8 % patients. Stillbirth occurred in 3.6 % patients. No thromboembolic event was noted in any of the patients. None of the patients had any documented thrombocytopenia or clinical fracture.
Low molecular weight heparin can be used in pregnancy for various indications as an alternative to unfractionated heparin or warfarin as it is efficacious and safe.
评估孕期因各种适应证使用低分子量肝素的安全性和有效性。
对印度北部一家三级医院在3年期间（2010 - 2012年）因各种适应证接受低分子量肝素（LMWH）治疗的所有患者进行了详细的回顾性分析。
在3年期间，55例患者因各种适应证接受了LMWH治疗。使用的是依诺肝素（1毫克/千克体重，每日一次/每日两次皮下注射）。适应证包括：60%的患者为瓣膜置换术后的瓣膜性心脏病、心房颤动或血栓；7%的患者为慢性深静脉血栓形成（DVT）；9.1%的患者为易栓症；18%的患者为复发性流产；5.5%的患者为DVT预防。7.2%的患者发生流产；10.9%的患者出现胎儿生长受限；1.8%的患者出现羊水过少、先兆子痫、妊娠期高血压、前置胎盘、胎盘早剥和产后出血。3.6%的患者发生死产。所有患者均未发生血栓栓塞事件。所有患者均无记录在案的血小板减少症或临床骨折。
低分子量肝素在孕期可用于各种适应证，作为普通肝素或华法林的替代药物，因为它有效且安全。
