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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 ...
Prior to the introduction of direct factor Xa inhibitors, vitamin K antagonists such as warfarin were the only oral anticoagulants for over 60 years, and together with heparin have been the main blood thinners in use. People admitted to hospital requiring blood thinning were started on an infusion of heparin infusion, which thinned blood ...
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]
Warfarin should not be given to people with heparin-induced thrombocytopenia until platelet count has improved or normalised. [39] Warfarin is usually best avoided in people with protein C or protein S deficiency, as these thrombophilic conditions increase the risk of skin necrosis, which is a rare but serious side effect associated with ...
[5] [88] Similarly, pregnant women are treated with low molecular weight heparin until after delivery to avoid the known teratogenic effects of warfarin, especially in the early stages of pregnancy, but it can be used while breastfeeding. [68]
Use during pregnancy appears to be safe for the baby. [11] Enoxaparin is in the low molecular weight heparin family of medications. [11] Enoxaparin was first made in 1981 and approved for medical use in 1993. [12] [11] It is on the World Health Organization's List of Essential Medicines. [13]
The most commonly used anticoagulants in clinical practice, warfarin and the heparin series of anticoagulants and fondaparinux, act to inhibit the action of Factor Xa in various degrees. Traditional models of coagulation developed in the 1960s envisaged two separate cascades, the extrinsic (tissue factor (TF)) pathway and the intrinsic pathway.