Management of heparin allergy during pregnancy with danaparoid

Blood Coagul Fibrinolysis. 2001 Mar;12(2):157-9. doi: 10.1097/00001721-200103000-00011.

Abstract

We report a patient who presented with a left proximal deep vein thrombosis at 25 + 5 weeks gestation. She developed a severe urticarial rash 3 weeks following initiation of therapy with Enoxaparin. The patient was heterozygous for the factor V Leiden mutation. She was treated with subcutaneous twice-daily danaparoid (Orgaran) for the remainder of the pregnancy, achieving anti-Xa levels in the therapeutic range 0.5-1.0 IU/ml. Delivery was at term by caesarean section 2 days after spontaneous rupture of membranes and failure to progress in labour. Danaparoid was withheld during this time. Danaparoid was restarted 3 h post delivery and the patient anticoagulated with warfarin in the post-partum period. There was no recurrence of thrombosis or bleeding events during therapy with danaparoid. No anti-Xa activity was demonstrated in breast milk.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cesarean Section
  • Chondroitin Sulfates / administration & dosage
  • Chondroitin Sulfates / analysis
  • Chondroitin Sulfates / therapeutic use*
  • Dermatan Sulfate / administration & dosage
  • Dermatan Sulfate / analysis
  • Dermatan Sulfate / therapeutic use*
  • Drug Combinations
  • Drug Hypersensitivity*
  • Enoxaparin / adverse effects*
  • Enoxaparin / therapeutic use
  • Factor V / genetics
  • Factor Xa Inhibitors
  • Female
  • Gestational Age
  • Heparitin Sulfate / administration & dosage
  • Heparitin Sulfate / analysis
  • Heparitin Sulfate / therapeutic use*
  • Heterozygote
  • Humans
  • Injections, Subcutaneous
  • Milk, Human / chemistry
  • Mutation
  • Pregnancy
  • Venous Thrombosis / drug therapy*

Substances

  • Drug Combinations
  • Enoxaparin
  • Factor Xa Inhibitors
  • factor V Leiden
  • Dermatan Sulfate
  • Factor V
  • Chondroitin Sulfates
  • Heparitin Sulfate
  • danaparoid