Mohzari Yahya A, Asdaq Syed M B, Bamogaddam Reem F, Alattas Khlood, Asalmi Sami, Alshuraim Renad A
Department of Clinical Pharmacy, King Saud Medical City, Riyadh, KSA.
Department of Pharmacology and Therapeutics, College of Pharmacy, AlMaarefa University, Riyadh, KSA.
J Taibah Univ Med Sci. 2021 Jan 20;16(2):292-294. doi: 10.1016/j.jtumed.2020.12.016. eCollection 2021 Apr.
Although there is a remarkably high risk of venous thromboembolism (VTE) during pregnancy and postpartum, a cautious approach is needed while initiating therapeutic and prophylactic anticoagulant therapy. The merits of heparin for thromboprophylaxis in postpartum patients are exaggerated, and its risk is generally overlooked. This study aimed to report the inappropriate use of anticoagulants in postpartum patients. The patient in this report was a 31-year-old healthy woman who had had a normal spontaneous vaginal delivery and visited the hospital a 3-day history of small itchy blisters at the enoxaparin injection sites. An examination revealed class II obesity. The Naranjo Scale assessment showed the possibility of an enoxaparin-induced hypersensitivity reaction. The clinical care team decided to discontinue the heparin. A follow-up examination did not show any signs of VTE. Although many pregnant and postnatal women might need VTE prophylaxis, routine anticoagulation for such a population is not essential. Clinicians should weigh the risks versus benefits to avoid any adverse drug reactions that may occur with this class of medication.
尽管在妊娠和产后期间静脉血栓栓塞症(VTE)的风险非常高,但在开始治疗性和预防性抗凝治疗时仍需谨慎。肝素在产后患者血栓预防中的优点被夸大了,而其风险通常被忽视。本研究旨在报告产后患者抗凝剂的不当使用情况。本报告中的患者是一名31岁的健康女性,她自然阴道分娩正常,因依诺肝素注射部位出现小的瘙痒性水疱并有3天病史而到医院就诊。检查发现为II级肥胖。Naranjo量表评估显示有依诺肝素引起的过敏反应的可能性。临床护理团队决定停用肝素。随访检查未显示VTE的任何迹象。尽管许多孕妇和产后妇女可能需要预防VTE,但对这类人群进行常规抗凝并非必不可少。临床医生应权衡风险与益处,以避免这类药物可能发生的任何药物不良反应。