Prophylactic dosing adjustment in pregnancy based upon measurements of anti-factor Xa levels
- 1 November 2005
- journal article
- Published by Taylor & Francis Ltd in The Journal of Maternal-Fetal & Neonatal Medicine
- Vol. 18 (5), 329-331
- https://doi.org/10.1080/14767050500275796
Abstract
To determine the necessity for monitoring of anti-factor Xa levels in pregnant women taking low molecular weight heparin (LMWH). A review of a hematological database with chart review was undertaken to identify patients on LMWH. Levels were drawn monthly. They were considered suboptimal if prophylactic and therapeutic doses of LMWH had an anti-Xa value <0.2 U/mL and 0.6 U/mL, respectively. Variables of interest included age, parity, thrombophilias, and antiphospholipid antibody syndrome. Of 30 patients, three required therapeutic-dose LMWH and 27 were on prophylaxis. Sixty-six percent on a therapeutic dose required a dose change, whereas 11% on a prophylactic dose were changed (p = 0.013). None of the variables were predictive of a need for change. One thromboembolic event was noted while on prophylactic-dose LMWH. No single variable is predictive of a need for dose change. Patients on a therapeutic dose were more likely to need change.Keywords
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