Use of antithrombotic agents during pregnancy

A ntithrombotic therapy during pregnancy is used for.*.*- the treatment and prophylaxis of venous thromboem¬ bolic disease, for the prevention and treatment of systemic embolism associated with valvular heart disease and/or prosthetic heart valves, and for the prevention of fetal growth retardation and pregnancy loss in patients with antiphospholipid antibodies and in patients with pregnancy-induced hypertension. Since antithrombotic agents have the potential to produce complications in both mother and fetus, their use during pregnancy raises concerns. Guide¬ lines are difficult to establish because the evidence upon which recommendations are based is derived primarily from level V studies in pregnant patients. This chapter reviews the fetal and maternal effects of antithrombotic agents, including oral anticoagulants, unfractionated hep¬ arin, low-molecular-weight heparins (LMWHs), and aspi