Both unfractionated heparin and LMWH are safe and effective in treating thromboembolic disease in pregnancy. Neither crosses the placenta, and their efficacies in treating DVT and PE are essentially equivalent. However, LMWH has a lower incidence of bleeding complications, heparin-induced thrombocytopenia, and osteoporosis as compared with heparin.5 Osteoporosis is a serious complication of full-dose heparin during pregnancy, with fractures occurring in 2% of treated women.5 LMWH does not appear to accelerate bone density loss. Warfarin is teratogenic and should not be administered during pregnancy.
- LMWH subcutaneously throughout pregnancy and for several months postpartum.
5. Ginsberg JS, Bates SM. Management of venous thromboembolism during pregnancy. J Thromb Haemost 2003;1:1435-42.
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