Fast Five Quiz: Test Your Knowledge of Venous Thromboembolism

Cheong Jun Lee, MD


December 03, 2018

Owing to its relative safety for the fetus, heparin is the anticoagulant of choice during pregnancy. Specifically, low-molecular-weight heparin (LMWH) is recommended over unfractionated heparin (UFH) by the American College of Chest Physicians, on the basis of its ease of use and better efficacy and safety profile. Heparin therapy should be discontinued immediately before delivery. Both heparin and warfarin therapy may be given to patients postpartum.

Warfarin crosses the placenta and may cause fetal bleeding and teratogenicity. The teratogenic effects of warfarin occur mainly in the first trimester. Both UFH and LMWH do not cross the placental membrane.

Because there is little information on maternal and fetal safety of direct oral anticoagulants (apixaban, dabigatran, rivaroxaban), these agents are avoided during pregnancy.

Alteplase is a thrombolytic agent, not an anticoagulant. Pregnancy is an absolute contraindication for thrombolysis.

For more on anticoagulants and thrombolytics in pregnancy, read here.


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