American Society of Hirudotherapy

Management and Outcome of Heparin-Induced Thrombocytopenia in Pregnancy: A Systematic Review

Systematic review published in Cardiovascular & hematological agents in medicinal chemistry (2015)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Systematic reviewDrug DevelopmentChaudhary RK et al. · Cardiovascular & hematological agents in medicinal chemistry, 2015

Abstract

OBJECTIVE: Safety and efficacy of therapeutic agents used for heparin-induced thrombocytopenia are not established in pregnancy. METHODS: MEDLINE database was searched in November 2014 to identify all patients who received therapy for HIT during pregnancy. RESULTS: A total of 12 patients with the median age of 28 years (range 21-39) were diagnosed with HIT at the median gestational age of 20 weeks (range 5-34). Clinical probability (4T) score for HIT was high (50%) or intermediate (50%) and associated with thrombosis in 50%. Patients were initially managed with lepirudin (33%), argatroban (25%), danaparoid (25%) or fondaparinux (17%) and ultimately bridged to vitamin K antagonist or maintained on lepirudin. All patients had resolution of HIT. Complications included therapeutic abortion prior to valve replacement for valve thrombosis (8%), preterm delivery (18%) and preeclampsia (8%). Except for one instance of hypoplastic lung related to preterm delivery, none of the other newborns had any complications during delivery. CONCLUSION: Confirmed cases of HIT in pregnant patients appear to be rare. Within the limits of retrospective analysis, the use of argatroban, danaparoid, fondaparinux and lepirudin may be effective in preventing the thrombotic complications of HIT in pregnancy. The effect of HIT or its therapy on obstetrical complications cannot be determined based on this study since many of the obstetrical complications are common in otherwise healthy pregnancies. Although this study did not identify any fetal teratogenicity except hypoplastic lung related to preterm delivery, small number of cases treated with various therapies precludes any definite conclusion.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleResearch Support, Non-U.S. Gov'tSystematic Review
Indexed MeSH termsAnticoagulantsFemaleHeparinHumansPregnancyRetrospective StudiesThrombocytopenia

Summary

Management and Outcome of Heparin-Induced Thrombocytopenia in Pregnancy: A Systematic Review.

Why This Matters for Hirudotherapy

This study searched MEDLINE to identify all reported patients who received therapy for heparin-induced thrombocytopenia (HIT) during pregnancy, finding 12 cases managed with lepirudin (33%), argatroban, danaparoid, or fondaparinux. All patients achieved resolution of HIT, though complications included preterm delivery, preeclampsia, and one therapeutic abortion. The abstract identifies lepirudin only by name without describing its origin or mechanism, and makes no mention of leeches, hirudin, or hirudotherapy, so a defensible connection to ASH's domain is not established by this article. Additionally, the extremely small number of identified cases treated with various therapies precludes any definite conclusion regarding safety or obstetrical outcomes.

Citation

Management and Outcome of Heparin-Induced Thrombocytopenia in Pregnancy: A Systematic Review

Chaudhary RK et al. · Cardiovascular & hematological agents in medicinal chemistry, 2015

DOI

Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026

This website provides educational information and does not constitute medical advice, diagnosis, or treatment recommendations. Medicinal leech therapy carries clinically meaningful risks and should be performed only by qualified clinicians under institutionally approved protocols. FDA 510(k) clearance for medicinal leeches is limited to specific indications; investigational and off-label discussions are labeled accordingly. For patient-specific guidance, consult a qualified healthcare provider.