Venous thromboembolic disease is rare; however, it constitutes an important cause of maternal and fetal morbidity and mortality. Pregnancy per se is a persistent thrombogenic state; thus, the risk of thromboembolic events is increased in this condition and is even higher in the early postpartum period, especially in women undergoing cesarean section. The pharmacological prophylaxis and treatment of thromboembolic complications are usually carried out through anticoagulation. In pregnancy, however, caution is necessary since the chosen therapy must weigh the risks to the fetus. Anticoagulation during pregnancy, when indicated, cannot be performed with warfarin, as it may cause congenital anomalies. Guidelines based on clinical practice and expert opinion recommend the use of unfractionated heparin and/or low molecular weight heparin because they do not cross the placenta. The Sistema Único de Saúde has been compelled, by court order, to provide enoxaparin to pregnant women, including those presenting with deep vein thrombosis during pregnancy. The objective of this report is to review the specialized literature and seek evidence on the efficacy and safety of enoxaparin in venous thromboembolic disease.
O registro foi originalmente publicado em português. A versão em inglês foi traduzida com o apoio de inteligência artificial.
Abstract
Venous thromboembolic disease is rare; however, it constitutes an important cause of maternal and fetal morbidity and mortality. Pregnancy per se is a persistent thrombogenic state; thus, the risk of thromboembolic events is increased in this condition and is even higher in the early postpartum period, especially in women undergoing cesarean section. The pharmacological prophylaxis and treatment of thromboembolic complications are usually carried out through anticoagulation. In pregnancy, however, caution is necessary since the chosen therapy must weigh the risks to the fetus. Anticoagulation during pregnancy, when indicated, cannot be performed with warfarin, as it may cause congenital anomalies. Guidelines based on clinical practice and expert opinion recommend the use of unfractionated heparin and/or low molecular weight heparin because they do not cross the placenta. The Sistema Único de Saúde has been compelled, by court order, to provide enoxaparin to pregnant women, including those presenting with deep vein thrombosis during pregnancy. The objective of this report is to review the specialized literature and seek evidence on the efficacy and safety of enoxaparin in venous thromboembolic disease.
