Published online Mar 26, 2024. doi: 10.12998/wjcc.v12.i9.1634
Peer-review started: October 20, 2023
First decision: January 25, 2024
Revised: February 3, 2024
Accepted: March 1, 2024
Article in press: March 1, 2024
Published online: March 26, 2024
Low-molecular-weight heparins (LMWH) are the most commonly used anticoagulants during pregnancy. It is considered to be the drug of choice due to its safety in not crossing placenta. Considering the beneficial effect in the impro
Herein we present a case series of three pregnant women diagnosed with preeclampsia on LMWH therapy during pregnancy. All the cases experienced catastrophic hemorrhagic events. After reviewing the twenty-one meta-analyses, the bleeding risk related with LMWH seems ignorable. Only one study analyzed the bleeding risk of LMWH and found a significantly higher risk of developing PPH in women receiving LMWH. Other studies reported minor bleeding risks, none of these were serious enough to stop LMWH treatment. Possibilities of bleeding either from uterus or from intrabdominal organs in preeclampsia patients on LMWH therapy should not be ignored. Intensive management of blood pressure even after delivery and homeostasis suture in surgery are crucial.
Consideration should be given to the balance between benefits and risks of LMWH in patients with preeclampsia.
Core Tip: Benefits and risks of low molecular weight heparins in pregnant patients diagnosed with preeclampsia should be carefully assessed. Strict control of blood pressure is needed to prevent further bleeding events.