- LMWH should be given daily in two subcutaneous divided doses (in
view of recognised alterations in the pharmacokinetics of dalteparin and
enoxaparin during pregnancy) titrated against the woman’s booking or
most recent weight.
- Tinzaparin may be administered once daily.
- Routine
measurement of peak anti-Xa activity for patients on LMWH is not
recommended except in women at extremes of body weight (< 50 kg and
> 90 kg) or with other complicating factors (for example with renal
impairment or recurrent VTE) putting them at high risk.
- Peak anti-Xa (3
hours post-injection) should be 0.5–1.2 units/ml.
- Routine platelet count monitoring should not be carried out (unless unfractionated heparin has been given).
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