A prospective trial showing the safety of adjusted-dose enoxaparin for thromboprophylaxis of pregnant women with mechanical prosthetic heart valves

Abstract

Objective: To determine whether dosage adjustment of enoxaparin during pregnancy, to maintain a peak anti-Xa of 1.0 to 1.2 U/mL, is safe for women with mechanical prosthetic heart valves (MPHV). Design: A prospective observational study. Setting: This study was performed at Charlotte Maxeke Johannesburg Academic Hospital from 2007 to 2009. Population: Fifteen women with MPHVs. Methods: Women were treated with enoxaparin with dosage adjustment to achieve a peak anti-Xa of 1.0 to 1.2 U/ mL. Main Outcome Measures: Main outcomes measured were prosthetic valve thrombosis, bleeding, and maternal mortality. Results: There was no maternal mortality. None of the women developed valvular thrombosis during pregnancy. In all, 2 women developed epistaxis and another developed spotting per vaginum. Conclusion: Our data show that enoxaparin may be administered safely during pregnancy to pregnant women with MPHV when there is dosage adjustment throughout pregnancy to maintain an anti-Xa of 1.0 to 1.2 U/mL. © The Author(s) 2011.