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Women with acute venous thromboembolism, mechanical heart valves, certain
cardiac arrythmias, and cardiomyopathy may require therapeutic (i.e., full dose) anticoagulation during pregnancy and postpartum. Prior to delivery, such anticoagulation is discontinued to reduce risk for excessive bleeding at delivery. Precisely when after delivery should full-dose anticoagulation be resumed? To evaluate the optimal timing, investigators in Quebec retrospectively reviewed medical records associated with 83 cesarean deliveries and 149 vaginal deliveries in women who received full-dose anticoagulation.
Postdelivery, major hemorrhage (significant bleeding after resumption of anticoagulation requiring surgery, hospital readmission, intensive care unit admi…