Anticoagulation with argatroban in a parturient with heparin-induced thrombocytopenia.
Publication/Presentation Date
1-1-2010
Abstract
Unfractionated heparin and low-molecular-weight heparin are currently the anticoagulants of choice for the prevention of recurrent thromboembolic disease during pregnancy. However, heparin-induced thrombocytopenia contraindicates the use of unfractionated heparin and low-molecular-weight heparin. We describe a patient who was admitted to our hospital with deep vein thrombosis at 18 weeks of gestation and who developed heparin-induced thrombocytopenia during her antenatal care. Therapeutic anticoagulation was initially achieved with argatroban, then changed to fondaparinux. During early labor, fondaparinux was discontinued and intravenous argatroban was substituted. Argatroban was discontinued during transition to active labor. After return of a normal partial thromboplastin time, combined spinal-epidural analgesia was induced for routine completion of labor and vaginal delivery. We discuss the decisions made in the maintenance of this patient's anticoagulation during the peripartum period as well as timing of her neuraxial labor analgesia.
Volume
19
Issue
1
First Page
82
Last Page
87
ISSN
1532-3374
Published In/Presented At
Ekbatani, A., Asaro, L. R., & Malinow, A. M. (2010). Anticoagulation with argatroban in a parturient with heparin-induced thrombocytopenia. International journal of obstetric anesthesia, 19(1), 82–87. https://doi.org/10.1016/j.ijoa.2009.01.012
Disciplines
Anesthesiology | Medicine and Health Sciences
PubMedID
19625181
Department(s)
Department of Anesthesiology
Document Type
Article