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Article Excerpt
Despite the increased risk of thrombosis during pregnancy and the postpartum period, most women do not require anticoagulants. In most cases, the risks of anticoagulant use outweigh the benefits. The risk of maternal bleeding complications with heparin or low molecular weight heparin (LMWH) is reported to be as high as 2%.1,2
In addition to maternal risks, anticoagulants may pose fetal risks, even with the use of agents that do not cross the placenta. There is a fine balance of hemostatic factors at the utero-placental interface,3 and in most cases, this balance is achieved with the normal hemostatic changes of pregnancy.
This is not necessarily true in women with a history of thrombosis or thrombophilia. In women with a history of VTE who receive anticoagulants, the risk of a recurrent event in pregnancy is 0% to 2%,2,4,5 but in women who do not receive anticoagulants,...
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