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Evidence summaries

Low-Molecular Weight Heparins in Pregnancy

The number of adverse events with low-molecular weight heparin (LMWH) during pregnancy may be small, but there are no RCTs comparing LMWH with unfractionated heparin. Level of evidence: "C"

A systematic review 1 including 40 studies (3 RCTs) on thromboprophylaxis with a total of 728 pregnancies was abstracted in DARE. Major maternal adverse events were 18 local and generalized skin reactions, 27 bleeding complications, 9 thomboembolic events, 8 DVT, 1 bilateral renal vein thrombosis, 4 pulmonary emboli, 1 hepatic infarction, and 4 cases of thrombophlebitis.

Comment: The quality of evidence is downgraded by imprecise results (few patients in RCTs) and limitations in review methodology.

Primary/Secondary Keywords