Clexane in pregnancy - Christina Cherry

General information about Clexane®

Clexane ® is the trade name of a drug with the active ingredient enoxaparin. This belongs to the group of low molecular weight heparins and is said to inhibit blood clotting by inhibiting the activity of a coagulation factor (factor Xa).

Clexane ® is used for Prophylaxis of thrombosis, for the therapy of thrombosis and pulmonary embolism and to Anticoagulation for other indications (e.g.. atrial fibrillation). Clexane ® is usually prescribed in a dosage of 0.4 ml for thrombosis prophylaxis before and after operations.
The patient can apply the pre-filled syringe under the skin.
A dreaded side effect are bleeding. It can also lead to waste platelets come.

Medication in pregnancy

In general, all medications during pregnancy should always be used together with the gynecologists to consider whether these drugs are absolutely necessary and whether they are Effects on the unborn to have.
If this is the case, the drug should be tried through a better one compatible preparation to replace.
In addition, it should be noted that most drugs have not been tested on pregnant women, so there is always an uncertainty about the safety most medication stays in pregnancy. Nonetheless, there are databases of retrospectively observed drug side effects on pregnant women.

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Use of Clexane® in pregnancy

In summary, it can be said that Clexane ® and other low molecular weight heparins are well tolerated in pregnancy and no unwanted side effects demonstrate.
There are only a few good studies on the subject of Clexane ® pregnancy, but it can also be assumed from animal studies that the substance does not pass onto the unborn child, this applies above all from the 13th week of pregnancy.
If you are pregnant, the indication for anticoagulant therapy with Clexane ® should be made very narrow.

Clexane ® is used in pregnancy for the following indications:

Treatment of Thrombosis in pregnancy
Use in artificial heart valves (note: especially. Marcumar for thinning blood is in the pregnancy absolutely contraindicated)
Prevention of birth complications with known coagulation disorders

A epidural for pain therapy of pregnant women during childbirth may take therapy with Clexane 40 ® do not take place because of the risk of Bleeding into the spinal canal is increased with narrowing of the spinal cord.

Even with possible Caesarean section if possible, this should not be done with therapy with Clexane 40®. Here it is recommended to at least suspend the dose on the day of the operative delivery. The next dose should also be at the earliest 12 hours after the operation respectively.

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What dosage do I need: 20, 40 or more mg?

The dosage of Clexane ® during pregnancy depends on individual circumstances. If possible, attempts are made to prevent any medication being administered during pregnancy. If this is not possible, the dose level is adjusted to the necessity and possibility. The motto here is: as high as necessary and as low as possible. The recommended dose level of Clexane ® can change during pregnancy. Regular blood tests can be used to determine how much of the active ingredient is necessary. In particular, if the pregnant woman can or is not allowed to move for various reasons, a higher dosage may be necessary. A dose adjustment is often indicated at the end of pregnancy. In some cases, a very high dose of 80 mg may be advisable. It is also important to skip Clexane ® for childbirth. That is, with a planned one Caesarean section the last injection with the active ingredient should be given at least 12 hours before the operation. If there is an unplanned caesarean section, the procedure is based on the obstetric situation and the last dose of Clexane ®. Patients who are at high risk of thrombosis or who are receiving high-dose prophylaxis may have one Switching to a so-called unfractionated heparin may make sense. In these cases, it is recommended to change the active substance in the 36th week of pregnancy or at the latest if labor has started regularly. The last unfractionated heparin is given 4 hours before birth. As a rule, Clexane ® is resumed in an individual dose 6-12 hours after birth. Should one Spinal anesthesia If you wish to give birth, the last dose of Clexane ® must have been 10-12 hours earlier. The next dose should be given 2-4 hours later in an adjusted dose.

What is the side effect?

The side effects of Clexane ® correspond to the general side effects of the preparation. There are also a few special features that you should consider. If the benefit-risk balance is well balanced, the side effects are minor. A big advantage is that Clexane ® does not cross the placental barrier. That means there are no side effects to the unborn. As a caution, however, it should be mentioned that in some cases studies show that Clexane ® may be less suitable for pregnant women. Studies have shown that treatment with Clexane ® poses a risk of clot formation in pregnant women with artificial heart valves. This can lead to a blockage in the heart valve and thus to death. In addition, Clexane ® can be used for several months during pregnancy contribute to bone loss. That means the active ingredient can reduce the risk of developing a so-called osteoporosis favor. The risk is greater if there is already a predisposition to osteoporosis or if an unhealthy lifestyle is preferred. The risk is correspondingly lower if there is the opposite. Individual advice and treatment from the treating gynecologist should be sought.

Also read our topic: Side effects of Clexane®

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