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Cardiovascular Drugs during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Dalteparin is another heparin that is used to treat ischemic complications. Frequency of birth defects was not increased among 3,390 infants exposed in the first trimester to dalteparin in the Swedish Birth Defects Registry (Kallen, 2019).
Inherited Thrombophilia
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Since that time, results have not been as encouraging. A retrospective, non-randomized study noted no improvement in pregnancy outcomes in women with thrombophilias who were and were not treated with thromboprophylaxis [75]. A cohort study showed that in women with a thrombophilia (heterozygous factor V, activated PC resistance, MTHFR 677 TT genotype, PS deficiency, heterozygous prothrombin 20210, antithrombin II deficiency, hyper-homocysteinemia, and/or PC deficiency) and a history of ≥3 first trimester losses, ≥2 second trimester losses, or a fetal death in the third trimester, enoxaparin 40 mg/day was associated with an approximate 80% rate of live births, similar to enoxaparin 80 mg/day [76]. Recent meta-analyses and reviews also found no increase in live birth rates in women with thrombophilias and pregnancy loss treated with anticoagulant therapy [77, 78]. The FRUIT trial compared low-dose aspirin with and without dalteparin in 139 women with thrombophilia and prior adverse pregnancy outcome. Dalteparin decreased the risk of recurrent hypertensive disease prior to 34 weeks’ gestation (risk reduction 8.7% [95% CI 1.9–15.5%]) but had no effect on fetal growth [79, 80].
Prevention and Treatment of Venous Thromboembolism
Published in Paloma Tejero, Hernán Pinto, Aesthetic Treatments for the Oncology Patient, 2020
Based on the analysis of several existing studies, we must conclude that VTED prophylaxis is certainly necessary in patients with cancer when they are hospitalized due to some acute, nonsurgical process. In the ARTEMIS study [8], which included 849 patients, 15.4% with cancer, two groups were compared, one receiving fondaparinux as prophylaxis and the other, placebo. There was a significant difference (p = .029) in venous thromboembolic events between the fondaparinux group (5.6%) and the placebo group (10.5%). This meant a 47% decrease in relative risk, and no differences were found regarding hemorrhagic complications. In the MEDENOX study [9] that compared one group receiving enoxaparin as prophylaxis and a placebo group, findings were similar: 5.5% of VTED in the enoxaparin group versus 14.9% in the placebo group, and a risk reduction of 63%. Likewise, no hemorrhagic differences were found. The same can be said about the PREVENT study [10], which included 3706 patients (5.1% with cancer). In this case, dalteparin was compared with placebo. Risk reduction was of 44% for the prophylaxis group, and again, no hemorrhagic complications were found.
12-year survival analysis of 322 Hintegra total ankle arthroplasties from an independent center
Published in Acta Orthopaedica, 2020
Mina Jane Zafar, Thomas Kallemose, Mostafa Benyahia, Lars Bo Ebskov, Jeannette Østergaard Penny
The patients were operated using a standard anterior approach, in accordance with the manufacturer’s instructions with relevant cutting guides and sizing regulations. The goal was neutral alignment in the AP view without collision laterally and the peak of the talus in side-view level between 40% and 50% from the frontal tibial edge. The operations were carried out using a tourniquet, and 1.5 g of cefuroxime was administered preoperatively. The foot was immobilized in a circular cast from the 2nd postoperative day for 3 weeks. The cast was converted to a removable boot (Don Joy type) for another 3 weeks, with weight-bearing as tolerated, followed by home physiotherapy if needed. Dalteparin 5000 I.E. s.c. was administered postoperatively for 3 to 5 days (this was prolonged in patients with risk factors).
Obstetric venous thromboembolism: a systematic review of dalteparin and pregnancy
Published in Journal of Obstetrics and Gynaecology, 2019
Margareta Hellgren, Oras Mistafa
The objective of this review was to analyse the efficacy of dalteparin in the treatment and prophylaxis of VTE in obstetric patients. The decision to study dalteparin only was made because of the absence of a comprehensive review concerning this LMWH in an obstetric population. While generally accepted as a single type of anticoagulant, differences in biochemical properties exist between LMWHs, which could be important for efficacy, dosing and drug elimination (Gerotziafas et al. 2007). Furthermore, it complements previously reported studies of the LMWHs enoxaparin and tinzaparin in this population (Lepercq et al. 2001; Nelson-Piercy et al. 2011). The secondary objectives were to analyse the dosing practices, the recommended measurements of determination of anticoagulant effects, and the adverse events associated with the treatment of VTE and thromboprophylaxis using dalteparin.
Current approaches in the treatment of catheter-related deep venous thrombosis in children
Published in Expert Review of Hematology, 2020
Julie Jaffray, Neil Goldenberg
The anti-factor Xa assays are used to monitor LMWHs. A single-center study prospectively evaluated the use of LMWH in newborn infants and found that time to achieve therapeutic anti-Xa levels was prolonged in preterm infants who also required higher weight-based doses of LMWH when compared to full-term infants [71]. Dalteparin, the only FDA-approved anticoagulant for children, is an LMWH that was studied as a subanalysis of the prospective, multicenter Kids-DOTT trial [55]. Eighteen children less than 21 years of age were enrolled in the substudy for VTE treatment. There were no symptomatic recurrent VTE events, medication-related serious adverse events, or clinically relevant bleeding events, and two minor bleeding events were noted [55].