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Case Reports
. 2011 May;17(5):CS56-9.
doi: 10.12659/msm.881753.

Use of fondaparinux in a pregnant woman with pulmonary embolism and heparin-induced thrombocytopenia

Michał Ciurzyński  1 , Krzysztof Jankowski, Bronisława Pietrzak, Natalia Mazanowska, Ewa Rzewuska, Robert Kowalik, Piotr Pruszczyk
Affiliations
Case Reports

Use of fondaparinux in a pregnant woman with pulmonary embolism and heparin-induced thrombocytopenia

Michał Ciurzyński et al. Med Sci Monit. 2011 May.

Abstract

Background: A serious complication of heparin treatment, heparin-induced thrombocytopenia (HIT) is rarely observed in pregnant women. Drug therapy during pregnancy should always be chosen to minimize fetal risk. The management of HIT in pregnancy represents a medical challenge. Unlike heparins, the anticoagulants used in patients with HIT do cross the placenta, with unknown fetal effects.

Case report: We present a case of a 24-year-old female presenting for care at 34 weeks of gestation with acute pulmonary embolism treated initially with unfractionated heparin (UFH) and low molecular weight heparin (LMWH), who developed HIT. She was then successfully treated with fondaparinux.

Conclusions: To the best of our knowledge, this is one of the first case reports describing a successful use of fondaparinux in the treatment of HIT in a third-trimester pregnant woman, providing a novel approach for this subset of patients.

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Figures

Figure 1
Figure 1
Transthoracic echocardiography showing saddle pulmonary thromboembolus.
Figure 2
Figure 2
Medication history. Arrow indicate the day of fondaparinux administration.
See this image and copyright information in PMC

References

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