Editorial
Management of anticoagulants during pregnancy
| The first 150 words of the full text of this article appear below. |
Although pregnancy induces a state of hypercoagulability, the thromoboembolic risks during a normal pregnancy are minor. This is not the case when the pregnant women has a native valvulopathy in atrial fibrillation, a mechanical prosthesis or a coagulation anomaly. The respective indications for heparin and oral anticoagulants reflect their respective advantages and disadvantages for the mother and child.
Historically, recommendations for anticoagulants during pregnancy have evolved with each new publication of results concerning their use.
Very early, coumarin induced embryopathies,1 especially during the first trimester, led to restricted use of oral anticoagulants in favour of heparin. However, it rapidly became apparent that heparin also had disadvantages, especially in women with prostheses. Heparin in these patients facilitated the evolution of the pregnancy by limiting fetal accidents but increased maternal haemorrhagic and thromboembolic risks.
The ease of use and safety provided by low molecular weight
heparins (LMWH) led to their widespread use,
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