Dahlman T C, Hellgren M S, Blombäck M
Department of Obstetrics and Gynecology, Karolinska Hospital, Stockholm, Sweden.
Am J Obstet Gynecol. 1989 Aug;161(2):420-5. doi: 10.1016/0002-9378(89)90535-8.
Twenty-six pregnant women were given prophylactic heparin treatment because of previous thromboembolic complications. The mean duration of treatment was 25 weeks (range, 6 to 32 weeks). The amount of heparin was adjusted to a plasma concentration of 0.08 to 0.15 IU/ml, measured as anti-factor Xa activity. This effect was compared with that on activated partial thromboplastin time. The average dose was 16,400 IU/24 hours or 225 IU/kg of body weight per 24 hours. When the plasma concentration was within the stipulated range, the dose was 234 IU/kg of body weight/24 hours. No significant prolongation of activated partial thromboplastin time was found in two thirds of the samples. Blood coagulation was either not activated or only slightly activated, as verified by a low level of fibrinopeptide A. Platelet counts and antithrombin III levels were generally not depressed. No thromboembolic complications occurred during the pregnancies or puerperium. Bleeding during delivery was not increased. No fractures of the spine caused by osteoporosis were found on radiologic examination post partum.
26名孕妇因既往有血栓栓塞并发症而接受预防性肝素治疗。治疗的平均持续时间为25周（范围为6至32周）。肝素剂量根据抗Xa因子活性测定的血浆浓度调整至0.08至0.15 IU/ml。将此效果与对活化部分凝血活酶时间的影响进行比较。平均剂量为16,400 IU/24小时或每24小时225 IU/kg体重。当血浆浓度在规定范围内时，剂量为234 IU/kg体重/24小时。三分之二的样本未发现活化部分凝血活酶时间有显著延长。纤维蛋白肽A水平较低证实，凝血未被激活或仅轻微激活。血小板计数和抗凝血酶III水平通常未降低。孕期或产褥期未发生血栓栓塞并发症。分娩时出血未增加。产后放射学检查未发现因骨质疏松导致的脊柱骨折。
