Massive subchorionic hematoma associated with enoxaparin.

BACKGROUND

The use of low-molecular-weight heparins is increasing for the prevention of thromboembolism in pregnancy. Subchorionic hematoma as a complication of anticoagulation therapy is rarely reported.

CASE: A persistent, massive subchorionic hematoma was diagnosed in a pregnant patient with atrial fibrillation and mitral stenosis. Enoxaparin was administered to maintain her trough anti-Xa level 0.5 units/mL or higher. The patient's peak anti-Xa levels never exceeded 1.05 units/mL. The patient underwent cesarean delivery at 34 6/7 weeks of gestation for preterm premature rupture of membranes.

CONCLUSION

Subchorionic hematoma is a potentially serious complication that can occur in pregnant patients receiving enoxaparin for the prevention of thromboembolism.