Anticoagulant Therapy In Pregnancy

Pregnancy is a complex physiologic state that presents unique challenges, particularly when managing medical conditions that require anticoagulant therapy. Anticoagulant therapy plays a crucial role in preventing and managing thromboembolic events, which can be particularly challenging during pregnancy due to the hypercoagulable state that naturally occurs. Pregnant women are at an increased risk of venous thromboembolism (VTE) due to hormonal changes, increased blood volume, and changes in blood flow. The preferred anticoagulants for treating and preventing VTE in most pregnant patients include low molecular weight heparins (LMWH) and unfractionated heparin (UFH). Vitamin K antagonists (eg, warfarin), on the other hand, are known teratogens and, therefore, relatively contraindicated except in patients at extremely high risk for VTE (eg, those with mechanical heart valves). For these extremely high-risk patients, there is no clearly preferred anticoagulant, and the agent chosen must be individualized through a shared decision-making process between the patient and the healthcare team.