Prophylactic use of danaparoid in high-risk pregnancy with heparin-induced thrombocytopaenia-positive skin reaction

Blood Coagul Fibrinolysis. 2003 Jul;14(5):485-7. doi: 10.1097/00001721-200307000-00009.

Abstract

We describe a case where danaparoid was used prophylactically in a high-risk twin pregnancy following the development of heparin-allergy while on prophylactic dalteparin. Danaparoid was substituted for dalteparin at 20 weeks of pregnancy following the development of a severe skin reaction while on the low molecular weight heparin. Although there was no significant fall in platelet count, an aggregation assay for heparin-induced thrombocytopaenia was positive. The skin lesions rapidly resolved following the change to subcutaneous danaparoid. Delivery was by emergency caesarian section at 35 weeks under a general anaesthetic, as a dose of danaparoid had been given 6 h prior to delivery. A sample of breast milk showed no anti-activated factor X activity. Danaparoid was continued post-delivery until the patient was fully warfarinized. To our knowledge, there are no previous reports of the use of danaparoid in this setting.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anticoagulants / therapeutic use*
  • Cesarean Section
  • Chondroitin Sulfates / therapeutic use*
  • Dermatan Sulfate / therapeutic use*
  • Drug Combinations
  • Drug Eruptions / etiology
  • Emergencies
  • Female
  • Heparin / adverse effects
  • Heparitin Sulfate / therapeutic use*
  • Humans
  • Infant, Newborn
  • Injections, Subcutaneous
  • Platelet Count
  • Pregnancy
  • Pregnancy Complications, Hematologic / prevention & control*
  • Pregnancy, High-Risk*
  • Pregnancy, Multiple
  • Puerperal Disorders / prevention & control
  • Pulmonary Embolism / prevention & control
  • Thrombocytopenia / etiology
  • Thrombosis / prevention & control*
  • Warfarin / administration & dosage
  • Warfarin / therapeutic use

Substances

  • Anticoagulants
  • Drug Combinations
  • Dermatan Sulfate
  • Warfarin
  • Heparin
  • Chondroitin Sulfates
  • Heparitin Sulfate
  • danaparoid