Management of Venous Thromboembolism
Authors: Emmanuel M. Bhaskar
Journal: Annals of Internal Medicine (2007)

Letters2 October 2007Management of Venous ThromboembolismEmmanuel M. Bhaskar, MDEmmanuel M. Bhaskar, MDFrom Sri Ramachandra Medical College and Research Institute, Porur, Chennai 600116, India.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-147-7-200710020-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In the recent guideline on management of venous thromboembolism (1), observations about the safety of heparin and warfarin during pregnancy need further clarification. Neither warfarin nor heparin is completely safe in pregnancy. The American College of Cardiology recommendations on anticoagulation for pregnant women with mechanical heart valves tell us these 3 interesting facts (2).First, warfarin is generally safe during the first 6 weeks of gestation and in the second trimester. The risk for fetal embryopathy is at its highest between 6 and 12 weeks of gestation. The drug is also safe in the third trimester, but ...References1. Snow V, Qaseem A, Barry P, Hornbake ER, Rodnick JE, Tobolic T, et al. Management of venous thromboembolism: a clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians. Ann Intern Med. 2007;146:204-10. [PMID: 17261857] LinkGoogle Scholar2. Bonow RO, Carabello BA, Chatterjee K, de Leon AC, Faxon DP, Freed MD, et al. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 guidelines for the management of patients with valvular heart disease) developed in collaboration with the Society of Cardiovascular Anesthesiologists endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. J Am Coll Cardiol. 2006;48:1-148. [PMID: 16875962] MedlineGoogle Scholar3. Chan WS, Anand S, Ginsberg JS. Anticoagulation of pregnant women with mechanical heart valves: a systematic review of the literature. Arch Intern Med. 2000;160:191-6. [PMID: 10647757] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Emmanuel M. Bhaskar, MDAffiliations: From Sri Ramachandra Medical College and Research Institute, Porur, Chennai 600116, India. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoManagement of Venous Thromboembolism: A Clinical Practice Guideline from the American College of Physicians and the American Academy of Family Physicians Vincenza Snow , Amir Qaseem , Patricia Barry , E. Rodney Hornbake , Jonathan E. Rodnick , Timothy Tobolic , Belinda Ireland , Jodi B. Segal , Eric B. Bass , Kevin B. Weiss , Lee Green , Douglas K. Owens , and Management of Venous Thromboembolism Amir Qaseem and Vincenza Snow Management of Venous Thromboembolism Christopher Hughes Management of Venous Thromboembolism Richard Schreiber Metrics 2 October 2007Volume 147, Issue 7Page: 519-520KeywordsHeartHeparinLow molecular weight heparinOsteoporosisPartial thromboplastin timePlacentaPregnancySafetySystematic reviewsVenous thromboembolism ePublished: 2 October 2007 Issue Published: 2 October 2007 Copyright & PermissionsCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...