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May 25, 1963

Use of Anticoagulants During Pregnancy

JAMA. 1963;184(8):664. doi:10.1001/jama.1963.03700210098024

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To the Editor:  —I was pleased to have Dr. Feldman's confirmation of our experience with the use of anticoagulants in the treatment of thrombophlebitis during pregnancy. He has raised an interesting and possibly valid point regarding the advisability of continuing this treatment through the labor and postpartum periods. We have usually discontinued or reduced the anticoagulant effect during labor because of the risk of bleeding, especially from lacerations and tears. However, in the few cases in which we have continued the anticoagulant effect at therapeutic levels, we have seen no serious hemorrhage. Perhaps we have been overly cautious. A greater experience with this specific phase of the problem may clarify the right course to pursue. We do restart the anticoagulation after labor in such cases because the greatest risk of extension and embolism occurs during the postpartum period.

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