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

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.