Are women who have thrombophilia managed differently during pregnancy?
Presently, if a pregnant patient has a thrombophilia and has had a blood clot prior to becoming pregnant, anticoagulation (i.e. use of a “blood thinning” medication) is recommended during and after pregnancy. Typically, low molecular weight heparin or heparin is the treatment of choice. In most ‘lower risk’ scenarios, low molecular weight heparin does not require any monitoring of blood levels. However, with higher dosing to achieve greater levels of anticoagulation (therapeutic levels), monitoring of blood levels (factor Xa level) is usually performed, to ensure an adequate level of anticoagulation and prevent bleeding complications with ‘too high’ levels. Low molecular weight heparin is more expensive than heparin. Recently, the unfractionated heparin recall (Baxter) has created shortages in unfractionated heparin, further encouraging the use of low molecular weight heparin. If a woman does not have an identified thrombophilia, and her prior clotting event occurred because of a tempo
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