Oral Concurrent Session 6 - Medical Complications
Oral Concurrent Sessions
Expedited Sessions
A randomized open label controlled trial was conducted. Women after delivery, who were intended to receive enoxaparin, were randomized to receive either enoxaparin treatment according to weight categories (≤ 90kg - 40mg; 91-130kg - 60mg; 131-170kg - 80mg; >170kg - 100mg) or as 1mg/kg (up to 100mg) .Plasma anti-Xa levels were obtained 4 hours after the second enoxaparin injection (day 2 of enoxaparin treatment). If the woman was still hospitalized, anti-Xa levels were also obtained at day 4. Assuming that 90% and 70% of women will have anti-Xa levels within the prophylactic range (0.2-0.6 units/ml) in the 1 mg/kg and weight categories groups, respectively, 124 women were required (2-sided alpha, 80% power).
The primary outcome was the proportion of women with anti-Xa levels within the prophylactic range (0.2-0.6 units/ml) at day 2.
Results: 64 and 60 women received enoxaparin according to weight categories and 1mg/kg, respectively; mean anti-Xa levels at day 2 were 0.19±0.06 and 0.34±0.09 (P < .0001) and 27 (42%) and 55 (92%) women reached the prophylactic range of anti-Xa at day 2, respectively (P < .0001). In the 25 women that had anti-Xa measurements at day 4, there was no difference in anti-Xa levels when compared to day 2. There were no adverse events or anti-Xa > 0.6 units/ml.
Conclusion:
Postpartum enoxaparin administration at 1mg/kg was superior to weight categories in reaching anti-Xa prophylactic levels without leading to overdose.
Rozan Haj, MD
Emek Medical Center
Afula, HaZafon, Israel
Manal Massalha, MD
Department of Obstetrics and Gynecology, Emek Medical Center
Dabburiya Village, HaZafon, Israel
Harel Eitam, MD
Emek Medical Center
Afula, HaZafon, Israel
Rula Kassabri, BSc
Emek Medical Center
Afula, HaZafon, Israel
Enav Yefet, MD, PhD
Department of Obstetrics and Gynecology, Baruch Padeh Medical Center Poriya
Tiberias, Israel, Israel
Zohar Nachum, MD
Emek Medical Center
Afula, Israel, Israel