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Table 28. Anticoagulation Strategies During Pregnancy
Antenatal Options
Method 1 Method 2 Method 3 Alternative
Method 4
1st trimester Warfarin ≤5 mg LMWH UFH LMWH
2nd trimester Warfarin Warfarin Warfarin LMWH
3rd trimester Warfarin Warfarin Warfarin LMWH
Delivery Planning
Method 1 Method 2
1 wk prior
Discontinue warfarin continuous
IV UFH
Dose-adjusted LMWH
36 h prior Continuous IV UFH Switch to continuous IV UFH
4–6 h prior Stop IV heparin Stop IV heparin
Adapted with permission from Otto CM, et al. Copyright 2021, American Heart
Association, Inc. and American College of Cardiolog y Foundation.
