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Pregnancy induced hypercoagulability is probably a physiologically adaptive mechanism to prevent post partum hemorrhage.[1] Pregnancy changes the plasma levels of many clotting factors, such as fibrinogen, which can rise up to three times its normal value.[2] Thrombin levels increase.[3] Protein S, an anticoagulant, decreases.The main issue with anticoagulation in pregnancy is that warfarin, the most commonly used anticoagulant in chronic administration, is known to have teratogenic effects on the fetus if administered in early pregnancy.[10][11] Still, there seems to be no teratogenic effect of warfarin before six weeks of gestation.[12] However, unfractionated heparin and low molecular weight heparin do not cross the placenta.[12]In general, the indications for anticoagulation during pregnancy are the same as the general population. This includes (but is not limited to) a recent history of deep venous thrombosis (DVT) or pulmonary embolism,zi xiu tang pollen capsule weight loss, a metallic prosthetic heart valve, and atrial fibrillation in the setting of structural heart disease.In addition to these indications, anticoagulation may be of benefit in individuals with lupus erythematosus,1box meizitang botanical slimming free shipping, individuals who have a history of DVT or PE associated with a previous pregnancy, and even with individuals with a history of coagulation factor deficiencies and DVT not associated with a previous pregnancy.[13]In pregnant women with a history of recurrent miscarriage, anticoagulation seems to increase the live birth rate among those with antiphospholipid syndrome and perhaps those with congenital thrombophilia but not in those with unexplained recurrent miscarriage.[14]A consensus on the correct anticoagulation regimen during pregnancy is lacking. Treatment is tailored to the particular individual based on her risk of complications.
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