Abstract
Thank you for your interest in our recent article. We agree that the risk of heparin-induced thrombocytopenia (HIT) is low in patients receiving low-molecular-weight heparin (LMWH).1Greer I.A. Nelson-Piercy C. Low-molecular-weight heparins for thromboprophylaxis and treatment of venous thromboembolism in pregnancy: a systematic review of safety and efficacy.Blood. 2005; 106: 401-407Crossref PubMed Scopus (615) Google Scholar Indeed, the ACCP does not recommend screening for HIT in patients treated with thromboprophylactic doses of LMWH. However, screening for HIT is recommended in patients taking therapeutic doses of LMWH.2Warkentin T.E. Greinacher A. Heparin-induced thrombocytopenia: recognition, treatment, and prevention: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy.Chest. 2004; 126: 311S-337SCrossref PubMed Scopus (747) Google Scholar, 3Gris J.C. Lissalde-Lavigne G. Quere I. Mares P. Monitoring the effects and managing the side effects of anticoagulation during pregnancy.Obstet Gynecol Clin North Am. 2006; 33: 397-411Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar In addition, cases of HIT associated with therapeutic doses of LMWH have occurred in pregnant women.1Greer I.A. Nelson-Piercy C. Low-molecular-weight heparins for thromboprophylaxis and treatment of venous thromboembolism in pregnancy: a systematic review of safety and efficacy.Blood. 2005; 106: 401-407Crossref PubMed Scopus (615) Google Scholar It represents a rare but important clinical entity. Thromboprophylaxis and pregnancy outcomes in asymptomatic women with inherited thrombophiliasAmerican Journal of Obstetrics & GynecologyVol. 200Issue 3PreviewOur objective was to evaluate the effect of thromboprophylaxis on pregnancy outcomes in asymptomatic women with inherited thrombophilias. Full-Text PDF Low-molecular-weight heparin in pregnancyAmerican Journal of Obstetrics & GynecologyVol. 201Issue 3PreviewI read with interest the article by Warren et al.1 The authors state that heparin and low-molecular-weight heparin increase the risk for bleeding, osteopenia, and thrombocytopenia. Some points need to be clarified. Compared with unfractionated heparin, the incidence of heparin-induced thrombocytopenia is rare (<0.1%) in patients receiving low-molecular-weight heparin.2,3 And there is no need to monitor platelet count in pregnant patients treated exclusively with low-molecular-weight heparin.3 Full-Text PDF
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