In a patient identified as having APLS because of recurrent pregnancy loss without history of thrombosis, but now has a new DVT/PE during pregnancy despite use of enoxaparin—for how long would you recommend anticoagulation?
Is it time limited since it may have been triggered by the pregnancy or is it indefinite since it is APLS associated?
Answer from: at Academic Institution
First, as far as I know, enoxaparin has not been proven to prevent pregnancy loss in obstetric APS. Second, we know that enoxaparin has not been shown to be as effective as heparin in preventing thrombotic events in APS. Third, the patient is pregnant, a thrombophilic state, separate from APS. All t...
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Answer from: Medical Oncologist at Community Practice
Assuming she was previously on a prophylactic dose of Lovenox and is now on 1mg/kg Q12H? Would discuss continuing with Lovenox through the postpartum period. Discussion on her decisions to breastfeed would then complicate whether you could switch to NOAC after birth. I would follow a D-dimer about 3...