Presentation Details
| Does unfractionated heparin versus low molecular weight heparin for thromboprophylaxis reduce complications near delivery? Sophia A.Cordes, Hani Faysal, Joaquin A.Calderon, Renxi Li, Sonya T.Gelfand, Mina Felfeli, Haeun Kim, Homa K.Ahmadzia. Department of Obstetrics and Gynecology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA |
Abstract
Introduction: To analyze whether the conversion of pregnant patients from low molecular weight heparin (LMWH) to unfractionated heparin (UFH) prior to delivery results in improved outcomes and harm reduction. Methods: A retrospective chart review of was conducted using data from 141 pregnant patients who delivered at a single university-affiliated hospital from January 2015 to September 2022 and were on LMWH or UFH during their pregnancy up until delivery. The primary outcome was the prevalence of hemorrhage associated morbidity in patients who were switched from LMWH to UFH prior to delivery. Secondary outcomes included neuraxial (NA) anesthesia complications, specifically related to anticoagulant use. Results: Out of a total of 141 patients, 38 were converted from LMWH to UFH prior to delivery. The conversion and non-conversion groups had comparable rates of postpartum hemorrhage during delivery (5.3% vs 14.6% respectively, aOR = 0.42, 95% CI 0.09-2.05, p=0.29). Conversion and non-conversion groups have no difference in estimated blood loss (406.7 ± 53.0 vs 562.6 ± 73.1 mL, p=0.98) or quantitative blood loss (655.9 ± 296.6 vs 667.4 ± 62.3 mL, p=0.89). Only two patients in the LMWH group experienced NA anesthesia complications, but these were unrelated to anticoagulant use (headaches). Conclusion: Our findings demonstrate that there is not a significant difference in postpartum hemorrhage in pregnant patients who were switched from LMWH to UFH prior to delivery compared to those who were not switched. The prevalence of NA anesthesia complications was not high enough to be comparable and unrelated to a bleeding complication.
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No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author.