Management and Outcome of Heparin-Induced Thrombocytopenia in Pregnancy: A Systematic Review
Systematic review published in 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.
Resumen
Management and Outcome of Heparin-Induced Thrombocytopenia in Pregnancy: A Systematic Review.
Por qué esto importa para la hirudoterapia
Este estudio realizó una búsqueda en MEDLINE para identificar a todos los pacientes reportados que recibieron tratamiento para la trombocitopenia inducida por heparina (HIT) durante el embarazo, encontrando 12 casos manejados con lepirudina (33 %), argatrobán, danaparoide o fondaparinux. Todos los pacientes lograron la resolución de la HIT, aunque las complicaciones incluyeron parto pretérmino, preeclampsia y un aborto terapéutico. El resumen identifica la lepirudina solo por su nombre, sin describir su origen ni mecanismo, y no menciona sanguijuelas, hirudina ni hirudoterapia, por lo que una conexión defendible con el dominio de ASH no se establece a partir de este artículo. Además, el número extremadamente pequeño de casos identificados tratados con diversas terapias impide cualquier conclusión definitiva respecto a la seguridad o los desenlaces obstétricos.
Citación
Management and Outcome of Heparin-Induced Thrombocytopenia in Pregnancy: A Systematic Review
Chaudhary RK et al. · Cardiovascular & hematological agents in medicinal chemistry, 2015
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026