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Adherence to a guideline for coumarins in pregnancy

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Abstract

Objective: To asses the adherence in daily clinical practice to a guideline for anticoagulation during pregnancy.

Methods: The Dutch anticoagulation clinics developed a pregnancy guideline for anticoagulant therapy in order to avoid foetal exposure to coumarins between the 6th and 9th week of gestation. Anticoagulation was studied in 282 prospectively-registered pregnant women, who were treated by 26 different anticoagulation clinics.

Results: The guideline was adhered to in 93% of treated women. Conforming to the guideline, the majority of patients commenced anticoagulation with heparin in the first trimester (n = 81) or started treatment from the second trimester onwards (n = 168). At the time of conception, 31 anticoagulated women were on coumarin treatment. In 13 of these patients (42%), coumarins were withdrawn before the 6th gestational week. In two pregnant women coumarin therapy started unintentionally during the first trimester of gestation.

Conclusion: The present study shows that the guideline under study is useful in daily clinical practice. A careful instruction of women of child-bearing age who need medication remains important.

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Authors and Affiliations

  1. Department of Paediatrics, Beatrix Children’s Hospital, University Hospital, Groningen, The Netherlands

    Dieneke van Driel & Judit Wesseling

  2. Department of Social Pharmacy and Pharmaepidemiology, Groningen University Institute of Drug Exploration (GUIDE), A. Deusinglaan 1, 9713 AV, Groningen, The Netherlands

    Kirsten ter Huurne & Lolkje T.W. de Jong-van den Berg

  3. Dutch Federation of Thrombosis Services, The Hague, The Netherlands

    Lya M. Geven-Boere

  4. Departments of Haematology and Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands

    Frits R. Rosendaal

  5. Pathology and Laboratory Medicine, University Hospital Groningen, Groningen, The Netherlands

    Eveline van der Vee

Authors
  1. Dieneke van Driel
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  2. Judit Wesseling
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  3. Kirsten ter Huurne
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  4. Lya M. Geven-Boere
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  5. Frits R. Rosendaal
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  6. Eveline van der Vee
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  7. Lolkje T.W. de Jong-van den Berg
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van Driel, D., Wesseling, J., ter Huurne, K. et al. Adherence to a guideline for coumarins in pregnancy. Pharm World Sci 26, 297–300 (2004). https://doi.org/10.1023/B:PHAR.0000042882.79387.a4

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  • DOI: https://doi.org/10.1023/B:PHAR.0000042882.79387.a4

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