Delayed hypersensitivity to low molecular weight heparin (LMWH) in pregnancy

Abstract

Heparin is currently the anticoagulant of choice for the prevention and treatment of thrombo-embolic disease in pregnancy because it does not cross the placenta [1]. The use of low molecular weight heparin (LMWH) is preferred to unfractionated heparin (UFH) as it is associated with a lower risk of bleeding, osteoporosis, heparin induced thrombocytopenia (HIT) and hypersensitivity reactions [2, 3, 4, 5]. Fondaparinux can be considered as a valuable alternative to LMWH during pregnancy in those patients with heparin induced skin reactions and/or HIT.