Challenging anticoagulation cases: A case of heparin-induced-thrombocytopenia in the first trimester of pregnancy

Catherine Anne Lovatt; Mark A Crowther

doi:10.1016/j.thromres.2021.09.001

Challenging anticoagulation cases: A case of heparin-induced-thrombocytopenia in the first trimester of pregnancy

Thromb Res. 2021 Nov:207:58-61. doi: 10.1016/j.thromres.2021.09.001. Epub 2021 Sep 14.

Authors

Catherine Anne Lovatt¹, Mark A Crowther²

Affiliations

¹ Faculty of Health Sciences, Department of Medicine, McMaster University, Hamilton, Ontario, Canada. Electronic address: kate.lovatt@medportal.ca.
² Faculty of Health Sciences, Department of Medicine, McMaster University, Hamilton, Ontario, Canada; St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.

PMID: 34547613
DOI: 10.1016/j.thromres.2021.09.001

Abstract

Heparin-induced thrombocytopenia in pregnancy is an uncommon phenomenon which rarely occurs in the first trimester. Therapeutic options and duration of therapeutic anticoagulation are varied amongst reported published cases. We report a 41-year-old female with confirmed HIT following anticoagulation with dalteparin for deep vein thrombosis (DVT). She was treated with therapeutic fondaparinux for 3 months followed by prophylaxis dosage until delivery and for 6 weeks thereafter. A review of reported cases of the development of HIT in the first trimester and subsequent clinical management is discussed.

Keywords: Anticoagulation; First trimester; Fondaparinux; Heparin-induced thrombocytopenia (HIT); Pregnancy.