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Obstetrics & Gynecology 2006;108:787-789
© 2006 by The American College of Obstetricians and Gynecologists
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CASE REPORTS

Massive Subchorionic Hematoma Associated With Enoxaparin

Richard H. Lee, MD1 and T. Murphy Goodwin, MD1

From the 1Los Angeles County–University of Southern California Medical Center, Women’s and Children’s Hospital, Los Angeles, California.

BACKGROUND: The use of low-molecular-weight heparins is increasing for the prevention of thromboembolism in pregnancy. Subchorionic hematoma as a complication of anticoagulation therapy is rarely reported.

CASE: A persistent, massive subchorionic hematoma was diagnosed in a pregnant patient with atrial fibrillation and mitral stenosis. Enoxaparin was administered to maintain her trough anti-Xa level 0.5 units/mL or higher. The patient’s peak anti-Xa levels never exceeded 1.05 units/mL. The patient underwent cesarean delivery at 34 6/7 weeks of gestation for preterm premature rupture of membranes.

CONCLUSION: Subchorionic hematoma is a potentially serious complication that can occur in pregnant patients receiving enoxaparin for the prevention of thromboembolism.






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