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Fetal warfarin syndrome appears in greater than 6% of children whose mothers took warfarin during pregnancy. [3] Warfarin has a low molecular weight so can pass from the maternal to fetal bloodstream through the tight filter-like junctions of the placental barrier. As the teratogenic effects of warfarin are well known, the medication is rarely ...
The main issue with anticoagulation in pregnancy is that warfarin, the most commonly used anticoagulant in chronic administration, is known to have teratogenic effects on the fetus if administered in early pregnancy. [11] [12] Still, there seems to be no teratogenic effect of warfarin before six weeks of gestation. [13]
Warfarin (brand name Coumadin) is a commonly prescribed blood thinner both in the inpatient and outpatient hospital settings. In pregnant women, warfarin is contraindicated and should be avoided as it crosses the placental barrier. Additionally, warfarin is listed as Pregnancy Category D, which means it has a risk of harming the fetus. [37]
Low molecular weight heparin (LMWH, such as enoxaparin) is generally used as an alternative. [44] Warfarin and LMWH may safely be used in breastfeeding. [44] When women experience recurrent pregnancy loss secondary to thrombophilia, some studies have suggested that low molecular weight heparin reduces the risk of miscarriage.
As they are administered by injection (intravenous, intramuscular or subcutaneous), they are less suitable for long-term treatment. [ 1 ] Argatroban (as well as the hirudins) is used for heparin-induced thrombocytopenia , a relatively infrequent yet serious complication of heparin treatment that requires anticoagulation (as it increases both ...
The PF4-heparin complex can activate platelets and may cause venous and arterial thrombosis. [8] When lepirudin binds to thrombin it hinders its prothrombic activity. [16] Three prospective studies, called the Heparin-Associated-Thrombocytopenia (HAT) 1,2, and 3, were performed that compared lepirudin with historical controls in the treatment ...
Treatment of this condition is very similar to treatment of non-gravid heart failure patients, however, safety of the fetus must be prioritized. For example, for anticoagulation due to increased risk for thromboembolism, low molecular weight heparin which is safe for use during pregnancy is used instead of warfarin which crosses the placenta. [37]
Warfarin is indicated for the prophylaxis and treatment of venous thrombosis and its extension, pulmonary embolism; [9] prophylaxis and treatment of thromboembolic complications associated with atrial fibrillation and/or cardiac valve replacement; [9] and reduction in the risk of death, recurrent myocardial infarction, and thromboembolic events such as stroke or systemic embolization after ...