Porcine Based Anticoagulant in Pregnancy Revisited: Analysis and Discussion of National Fatwa in Aligned with Istihalah Fiqh Concept in Clinical Practice

Abstract

Recent studies around the world have shown that there is an increment of maternal mortality due to the rising incidence of blood clot complication or commonly known as venous thromboembolism in pregnancies and during confinement. Women with high risk pregnancies are treated with low molecular weight heparin (LMWH) as the effective anti coagulant either during antenatal period or post delivery depending on their risk for certain duration. Thus, has shown to improve and reduce the maternal mortality and morbidity rate.Unfortunately, the usage of LMWH which are porcine in origin has raised a concern among Muslim health practitioner and public,although it isclinically proven to be the safest anti-coagulant treatment for pregnant women with complications following venous thromboembolism event.This article was meant to analyse the fiqh concept of istihalahbetween scholars and evidence, regarding the usage of porcine based LMWH among pregnant women. Fiqh method upon istihalah, references and content analysis; supported with more recent clinical evidences were analysed and elaborated regarding this issue and its clinical usage of LMWH upon pregnant mothers. There were unduly debate between Muslim scholars and Muslim health practitioners around the globe regarding the usage of porcine base LMWHas the best treatment in preventing and treating venous thromboembolism using LMWH. The istihalah concept has allowed many Muslim scholars in other countries to agree on the usage of LMWH in clinical practice. Nevertheless, Malaysian National Fatwa council has issued to forbid the usage of LMWH due to availability of other anticoagulant options. Yet; new evidences in which absent of porcine traces after manufacturing of LMWH proven safety profile of porcine base anticoagulant has emerged and has change the perspectives of clinical practice. These arguments hopefully able to facilitate the justification of istihalah concept in permissibility of LMWH usage in clinical practice among Muslim health practitioner and create public awareness.