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In pregnant women on low molecular weight heparin, we recommend to discontinue it 12 to 24 hours before the planned delivery: 98% agreement



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In pregnant women on low molecular weight heparin, we recommend to discontinue it 12 to 24 hours before the planned delivery: 98% agreement

Studies showed safety of performing an anesthetic block 12 hours after the last application of low molecular weight heparin at the prophylactic dose, and 24 hours after the last therapeutic dose of the medication, since the elimination half-life of the drug is 3 to 7 hours.(6,30)


Elastic stockings associated with early mobility should be recommended to all puerperal women: 98% agreement

The use of mechanical measures for the pregnant women hospitalized at the time of delivery (elastic stockings and intermittent pneumatic compression) and during the puerperium (elastic stockings) is recommended.(6)


CONCLUSION

Over the last years, the recommendation of investigation and management for primary or secondary prevention of thrombosis in women with a past and family history has been evolving. However, laboratory thrombophilia tests are still used more frequently than the literature suggests, generating unnecessary costs and anxiety.

Hormone replacement therapy or the use of hormonal contraceptives, both in women with no risk and in those with history or risk of thrombophilia, should be individualized, with an adequate selection by means of a careful medical history taking, by appropriate administration route and choice of hormones.

In pregnant women, there is clinical management recommended and well-defined based on literature, which guides the prophylactic and therapeutic orientations during pregnancy and puerperium. Whereas in cases of non-pregnant women, in which studies are scarce and the variables are many, this consensus was based on guidelines, studies, and the opinion of experts to define a standard care for patient.

Thus, interdisciplinary guidelines for the investigation and prevention of thromboembolism were established, collaborating to a better management of patients and minimizing risks. This is the first national consensus.




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