Acute Medicine | Medical problems in pregnancy 01 knowledge A

Anticoagulation in Pregnancy
Session Overview
Description
This session covers the use of anticoagulants in pregnancy, with specific reference to the acute management of venous thromboembolism (VTE) in pregnancy. The safety issues for the mother and fetus of unfractionated heparin (UH), low molecular weight heparins (LMWH) and warfarin are discussed.

Learning Objectives

By the end of this session you will be able to:

• Describe the advantages of low molecular weight heparin (LMWH) over unfractionated heparin (UH)
• Highlight why it is the treatment of choice in pregnancy
• List the adverse effects of warfarin on the developing fetus
• Liaise with a pregnant patient, her obstetrician and obstetric anaesthetist about peripartum management of anticoagulation

Pulmonary embolism is the leading cause of direct maternal death in the UK. Pregnancy is associated with a four fold increase in the risk of VTE. The increased risk begins early in the first trimester and before women access obstetric care. They may therefore commonly present to emergency departments and acute medical teams.

The common indications for anticoagulation in pregnancy include:

• Treatment of acute VTE
• Thromboprophylaxis in high risk patients
• Management of anticoagulation for metal heart valves

This session focusses on the anticoagulant management of VTE in pregnancy.