OBJECTIVE: To asses the adherence in daily clinical practice to a guideline for anticoagulation during pregnancy. METHODS: The Dutch anticoagulation clinics developed a pregnancy guideline for anticoagulant therapy in order to avoid foetal exposure to coumarins between the 6th and 9th week of gestation. Anticoagulation was studied in 282 prospectively-registered pregnant women, who were treated by 26 different anticoagulation clinics. RESULTS: The guideline was adhered to in 93% of treated women. Conforming to the guideline, the majority of patients commenced anticoagulation with heparin in the first trimester (n = 81) or started treatment from the second trimester onwards (n = 168). At the time of conception, 31 anticoagulated women were on coumarin treatment. In 13 of these patients (42%), coumarins were withdrawn before the 6th gestational week. In two pregnant women coumarin therapy started unintentionally during the first trimester of gestation. CONCLUSION: The present study shows that the guideline under study is useful in daily clinical practice. A careful instruction of women of child-bearing age who need medication remains important.
OBJECTIVE: To asses the adherence in daily clinical practice to a guideline for anticoagulation during pregnancy. METHODS: The Dutch anticoagulation clinics developed a pregnancy guideline for anticoagulant therapy in order to avoid foetal exposure to coumarins between the 6th and 9th week of gestation. Anticoagulation was studied in 282 prospectively-registered pregnant women, who were treated by 26 different anticoagulation clinics. RESULTS: The guideline was adhered to in 93% of treated women. Conforming to the guideline, the majority of patients commenced anticoagulation with heparin in the first trimester (n = 81) or started treatment from the second trimester onwards (n = 168). At the time of conception, 31 anticoagulated women were on coumarin treatment. In 13 of these patients (42%), coumarins were withdrawn before the 6th gestational week. In two pregnant womencoumarin therapy started unintentionally during the first trimester of gestation. CONCLUSION: The present study shows that the guideline under study is useful in daily clinical practice. A careful instruction of women of child-bearing age who need medication remains important.
Authors: Dieneke van Driel; Judit Wesseling; Pieter J J Sauer; Bert C L Touwen; Eveline van der Veer; Hugo S A Heymans Journal: Teratology Date: 2002-09
Authors: C Gohlke-Bärwolf; J Acar; C Oakley; E Butchart; D Burckhart; E Bodnar; R Hall; J P Delahaye; D Horstkotte; R Krémer Journal: Eur Heart J Date: 1995-10 Impact factor: 29.983
Authors: J Wesseling; D Van Driel; H S Heymans; F R Rosendaal; L M Geven-Boere; M Smrkovsky; B C Touwen; P J Sauer; E Van der Veer Journal: Thromb Haemost Date: 2001-04 Impact factor: 5.249