Use of antithrobomic agents in pregnancy and lactation: from the viewpoint of the cardiologist/rheumatologist (literature review)

Abstract

The review focuses on the main aspects of the use of antithrombotic agents in women during pregnancy and lactation. It summarises the reasons for frequent development of gestational hypercoagulable state, which provokes some obstetric complications (preeclampsia, etc.) and increases the possibility of the occurrence of serious clinical situations such as lower extremity deep vein thrombosis and pulmonary embolism, thrombotic/thromboembolic complications in thrombophilia and antiphospholipid syndrome of various genesis, as well as prosthetic heart valves. It provides a brief description of antithrombotic agent groups and advanced approaches to the selection of antithrombotic agents in pregnant and lactating women. This article discusses in details individual clinical situations during which the agents under discussion may be used during pregnancy and lactation (prevention of preeclampsia, treatment of thrombotic and thromboembolic complications, prophylaxis of the latter, if patients are required to be on bed rest for more than 24 hours, planning for caesarean section and epidural anaesthesia, and in thrombophilia, antiphospholipid syndrome, prosthetic heart valves) according to the current Guidelines.

Keywords

• antithrombotic agents
• pregnancy
• lactation