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Abstract

Antithrombotic Prophylaxis with Fondaparinux in Two Pregnant Women with Previous Cerebral Vein Thrombosis

Fondaparinux, a subcutaneous synthetic pentasaccharide that selectively inhibit factor Xa, seems to be a safe and efficacious alternative to low molecular weight heparin in prevention and treatment of venous thromboembolism in pregnant women who had developed severe adverse reactions to heparin. Two women with previous cerebral vein thrombosis received antithrombotic prophylaxis during pregnancy with fondaparinux 2.5 mg od because of previous hypersensitivity to low molecular weigh heparin. No thrombosis recurrence, maternal or fetal bleeding were observed, but both newborns were small for gestational age. Antithrombotic prophylaxis with fondaparinux was effective and safe in two pregnant women with previous cerebral vein thrombosis, but its potential side effects on fetal growth should be further elucidated. Low molecular weight heparin (LMWH) is the drug of choice for the treatment and prevention of venous thromboembolism (VTE) in pregnancy [1]. Adverse reactions to LMWH, i.e., local skin reactions, systemic rash and heparin induced thrombocytopenia (HIT) may occur and impose LMWH discontinuation and its avoidance thereafter [1]. Fondaparinux, a subcutaneous synthetic pentasaccharide that selectively inhibit factor Xa, seems to be a valid alternative to LMWH for both treatment and prophylaxis of VTE also during pregnancy [1], but data are limited to case reports or case series [2-8]. We report on the successful use of antithrombotic prophylaxis with fondaparinux in two pregnant women with previous cerebral vein thrombosis who had developed HIT (case 1) and severe skin reaction (case 2) during LMWH treatment. 15th,


Author(s):

Serena M Passamonti, Francesca Gianniello and Ida Martinelli



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