| When treating DVT in a pregnant woman, IV heparin should be dosed to maintain partial thromboplastin time (PTT) at twice normal, or low molecular weight heparin should be dosed to achieve constant Factor Xa levels. All patients should be switched to LMWH at discharge, and anticoagulation should be discontinued 24 to 36 hours prior to delivery, except for high-risk patients. Stop all anticoagulants with onset of active labor, and do not restart until 6 hours after delivery, to avoid hemorrhage. After delivery, anticoagulation is continued for 6 weeks, with either enoxaparin or warfarin (Coumadin).
Complications of a deep vein thrombosis include pulmonary embolism, and complications of heparin may include either hemorrhage or thrombocytopenia. |