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Fetal warfarin syndrome is a disorder of the embryo which occurs in a child whose mother took the medication warfarin (brand name: Coumadin) during pregnancy. Resulting abnormalities include low birth weight , slower growth , intellectual disability , deafness , small head size , and malformed bones , cartilage , and joints .
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]
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]
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.
It is administered intravenously (into a vein) or subcutaneously (below the skin). Heparin can exert an immediate anti-clotting effect which is useful for the treatment of acute symptoms. [36] Besides, heparin therapy is indicated for anticoagulation during pregnancy as it does not cross the placenta and is not associated with fetal malformations.
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 ...
Heparin, also known as unfractionated heparin (UFH), is a medication and naturally occurring glycosaminoglycan. [3] [4] Heparin is a blood anticoagulant that increases the activity of antithrombin. [5] It is used in the treatment of heart attacks and unstable angina. [3] It can be given intravenously or by injection under the skin. [3]
[52] [53] Warfarin's interference with G1a proteins has also been linked to abnormalities in fetal bone development in mothers who were treated with warfarin during pregnancy. [54] [55] Long-term warfarin and heparin usage have also been linked to osteoporosis. [56] [45] Another potentially severe complication associated with heparin use is ...