Objective
We wanted to assess the pharmacokinetics of subcutaneously administered Enoxaparin sodium during and after pregnancy. Study Design: Daily subcutaneous injections of Enoxaparin sodium (40 mg) were administered to 13 pregnant women. On three separate occasions, once early in pregnancy (12-15 weeks), even late in pregnancy (30-33 weeks), and once in the nonpregnant state (6-8 weeks post pactum), serial blood samples collected, and plasma was analyzed for anti-factor Ea activity. Analysis of variance was used for statistical analysis. P <0.05 was significant. Results: The time to maximum concentration and the mean residence time in the pregnancy compared with the state after the birth did not differ significantly. During the early and late pregnancy, maximum concentration and the last measurable anti-factor Ea activity were lower than in non-pregnant state (P <.05). The area under the plasma activity-versus-time curve was significantly lower than during pregnancy in the postpartum state (P <.05). Conclusion: The pharmacokinetics of Enoxaparin sodium are significantly different during pregnancy than in the same, if not pregnant women. The observed difference is probably due to the increased renal clearance of Enoxaparin during pregnancy. This finding has significant implications for appropriate dosing of Enoxaparin in pregnancy.
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