543412IMD Gerinnungszentrum Mannheim, Mannheim, Germany.
Institut für Transfusionsmedizin, 14903Charité Universitätsmedizin Berlin, Berlin, Germany.
Clin Appl Thromb Hemost. 2021 Jan-Dec;27:10760296211014575. doi: 10.1177/10760296211014575.
We analyzed data for women who received fondaparinux for ≥7 days during pregnancy. The study retrospectively included women who received fondaparinux pre-, peri- and/or postpartum for ≥7 days for prophylaxis/venous thromboembolism (VTE) treatment at German specialist centers (2004-2010). Data on pregnancy, VTE risk factors, anticoagulant treatment, pregnancy outcome and adverse events were extracted from medical records. 120 women (mean age 31.5 years) were included. Among 84 women with prior pregnancies, 41.0% had ≥1 abortion. Anticoagulation was indicated for prophylaxis in 92.5% cases, including 82.5% women with an elevated VTE risk (82.8% thrombophilia, 34.2% VTE history). All women received low-molecular-weight heparin (LMWH) as first-line therapy; 3 also unfractionated heparin. Treatment changed to fondaparinux, due to heparin allergy (41.7%) or heparin-induced thrombocytopenia (10.0%). Fondaparinux was generally well tolerated. Adverse events included bleeding events (n = 5), abortion (n = 2), premature births (n = 2), stillbirth (n = 1), arrested labors (n = 2), injection site erythema (n = 4) and unspecified drug hypersensitivity (n = 6). No VTE events or increased liver enzymes occurred during treatment. In this retrospective study, fondaparinux was effective and well tolerated. Trial registration: ClinicalTrials.gov NCT01004939.
我们分析了在妊娠期间接受≥7 天法安明治疗的女性的数据。本研究回顾性纳入了 2004 年至 2010 年期间在德国专科中心接受≥7 天的预防性/静脉血栓栓塞症(VTE)治疗的、在妊娠前、围产期和/或产后接受法安明治疗的女性。从病历中提取了妊娠、VTE 危险因素、抗凝治疗、妊娠结局和不良事件的数据。共纳入 120 名女性(平均年龄 31.5 岁)。在 84 名有既往妊娠史的女性中,41.0%有≥1 次流产史。92.5%的病例抗凝指征为预防,包括 82.5%的 VTE 风险升高(82.8%血栓形成倾向,34.2% VTE 病史)。所有女性均接受低分子肝素(LMWH)作为一线治疗;3 例还接受普通肝素。由于肝素过敏(41.7%)或肝素诱导的血小板减少症(10.0%),治疗转为法安明。法安明一般耐受良好。不良事件包括出血事件(n=5)、流产(n=2)、早产(n=2)、死胎(n=1)、产程停止(n=2)、注射部位红斑(n=4)和未明药物过敏(n=6)。治疗期间无 VTE 事件或肝酶升高。在这项回顾性研究中,法安明是有效和耐受良好的。试验注册:ClinicalTrials.gov NCT01004939。