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Low Molecular Weight Heparins

A Guide to Their Optimum Use In Pregnancy

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Abstract

The incidence of pulmonary embolism (PE) and venous thromboembolism (VTE) is higher in pregnant patients than in non-pregnant patients. The incidence of thrombosis in all pregnancies is reported to be between 0.05 and 1%, and an incidence as high as 3% may be present in women after caesarean section.

Anticoagulant medication is prescribed during pregnancy in patients presenting with VTE, thrombophilia abnormalities, or a history of PE or VTE. Since unfractionated heparin (UH) does not cross the placental barrier, it has become the gold standard anticoagulant therapy during pregnancy.

Oral anticoagulants may also be prescribed during the second trimester but they cross the placental barrier.

Low molecular weight heparins (LMWH) are effective, easy to use and have good safety profiles. The practical conditions of use have yet to be validated for pregnancy settings. In the absence of an approved indication, LMWH use during pregnancy is therefore the responsibility of the practitioner. However, several studies on LMWH as prophylaxis for PE or VTE have shown that such products are effective with good safety. Moreover, LMWH use is associated with reduced frequencies of thrombocytopenia and osteoporosis compared with UH use. Very few studies on LMWH use for the treatment of PE or VTE during pregnancy have been published, but the safety of LMWH use in this setting appears to be good.

The review of the use of LMWH in pregnancy settings includes recommendations on the practical conditions of use. In the absence of large-scale, randomised, double-blind trials in such settings (which are needed), we propose the use of LMWH as prophylaxis for PE and VTE during pregnancy, but not for the treatment of these conditions.

In prophylaxis settings, dalteparin sodium and enoxaparin sodium have been the most widely studied LMWH and we believe that priority should therefore be given to those products. Pending approval of LMWH for use in pregnancy, the use of LMWH off-label is the practitioner’s responsibility.

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References

  1. Sachs BP, Brown DA, Driscoll SG, et al. Maternal mortality in Massachusetts: trends and prevention. N Engl J Med 1987; 316: 607–72

    Article  Google Scholar 

  2. Bonnar J. Venous thromboembolism and pregnancy. Clin Obstet Gynecol 1981; 8(2): 455–73

    CAS  Google Scholar 

  3. Greer I. The special case of venous thromboembolism in pregnancy. Haemostasis 1998; 28 Suppl. 3: 22–34

    PubMed  CAS  Google Scholar 

  4. Ginsberg JS, Hirsh J, Turner DC, et al. Risks for the fetus of anticoagulant therapy during pregnancy. Thromb Haemost 1989; 61: 197–203

    PubMed  CAS  Google Scholar 

  5. Ginsberg JS, Kowalchuk G, Hirsh J, et al. Heparin therapy during pregnancy: risks for the fetus and mother. Arch Intern Med 1989; 149: 2233–6

    Article  PubMed  CAS  Google Scholar 

  6. Prandoni P, Lensing AW, Buller HR, et al. Comparison of subcutaneous low-molecular-weight heparin with intravenous standard heparin in proximal deep-vein thrombosis. Lancet 1992; 339: 441–5

    Article  PubMed  CAS  Google Scholar 

  7. Nurmohamed MT, Rosendaal FR, Buller HR, et al. Low-molecular-weight heparin versus standard heparin in general and orthopaedic surgery: a meta-analysis. Lancet 1992; 340: 152–6

    Article  PubMed  CAS  Google Scholar 

  8. Simonneau G, Sors H, Charbonnier B, et al. A comparison of low-molecular-weight heparin with unfractionated heparin for acute pulmonary embolism. The THESEE Study Group. N Engl J Med 1997; 337(10): 663–9

    Article  PubMed  CAS  Google Scholar 

  9. Ginsberg JS. Thromboembolism and pregnancy. Thromb Haemost 1999; 82(2): 620–5

    PubMed  CAS  Google Scholar 

  10. Ensom MH, Stephenson MD. Low-molecular-weight heparins in pregnancy. Pharmacotherapy 1999; 19(9): 1013–25

    Article  PubMed  CAS  Google Scholar 

  11. Warkentin TE, Levine MN, Hirsh J, et al. Heparin-induced thrombocytopenia in patients treated with low-molecular-weight heparin or unfractionated heparin. N Engl J Med 1995; 332: 1330–5

    Article  PubMed  CAS  Google Scholar 

  12. Monreal M, Lafoz E, Olive A, et al. Comparison of subcutaneous unfractionated heparin with a low molecular heparin (Fragmin) in patients with venous thromboembolism and contraindications to coumarin. Thromb Haemost 1994; 71: 7–11

    PubMed  CAS  Google Scholar 

  13. Barbour LA. Current concepts of anticoagulant therapy in pregnancy. Obstet Gynecol Clin North Am 1997 Sept; 24(3): 499–521

    Article  PubMed  CAS  Google Scholar 

  14. Frydman A. Low-molecular-weight heparins: an overview of their pharmacodynamics, pharmacokinetics, and metabolism in humans. Haemostasis 1996; 26: 24–38

    PubMed  CAS  Google Scholar 

  15. Green D, Hirsh J, Heit J, et al. Low molecular weight heparin: a critical analysis of clinical trials. Pharmacol Rev 1994; 46: 89–109

    PubMed  CAS  Google Scholar 

  16. Hirsh J, Levine MN. Low molecular weight heparin. Blood 1992; 79: 1–17

    PubMed  CAS  Google Scholar 

  17. Nelson-Piercy C. Low molecular weight heparin for obstetric thromboprophylaxis. Br J Obstet Gynaecol 1994; 101: 6–8

    Article  PubMed  CAS  Google Scholar 

  18. Hirsh J, Raschke R, Warkentin TE, et al. Mechanism of action, pharmacokinetics, dosing considerations, monitoring, efficacy, and safety. Chest 1995; 108: 258S–75S

    Article  PubMed  CAS  Google Scholar 

  19. Harenberg J, Wurzener B, Zimmermann R, et al. Bioavailability and antagonization of the low molecular weight heparin CY216 in man. Thromb Res 1986; 44: 549–54

    Article  PubMed  CAS  Google Scholar 

  20. Bratt G, Tornbohm E, Widlund L, et al. Low molecular weight heparins (Kabi 2165, Fragmin®): pharmacokinetics after intravenous and subcutaneous administration. Thromb Res 1986; 42: 613–20

    Article  PubMed  CAS  Google Scholar 

  21. Melissari E, Parker CJ, Wilson NV, et al. Use of low molecular weight heparin in pregnancy. Thromb Haemost 1992; 68: 652–6

    PubMed  CAS  Google Scholar 

  22. Forestier F, Daffos F, Capell-Pavlovsky M. Low molecular weight heparin (PK 10169) does not cross the placenta during the second trimester of pregnancy: study by direct fetal blood sampling under ultrasound [letter]. Thromb Haemost 1987; 57: 234

    PubMed  CAS  Google Scholar 

  23. Omri A, Dellaloye JF, Anderson H, et al. Low molecular weight heparin novo (LHN-1) does not cross the placenta during the second trimester of pregnancy. Thromb Haemost 1989; 1: 55–6

    Google Scholar 

  24. Harenberg J, Schneider D, Heilman L, et al. Lack of anti-factor Xa activity in umbilical cord vein samples after subcutaneous administration of heparin or low molecular mass heparin in pregnant women. Thromb Haemost 1993; 23: 314–20

    CAS  Google Scholar 

  25. Schneider DM, Heilmann L, Harenberg J. Placenta passage of low molecular weight heparin [in german]. Geburtshilfe Frauenheilkd 1995; 55: 93–8

    Article  PubMed  CAS  Google Scholar 

  26. Sturridge F, De Swiet M, Letsky E. The use of low molecular weight heparin for thromboprophylaxis in pregnancy. Br J Obstet Gynaecol 1994; 101: 69–71

    Article  PubMed  CAS  Google Scholar 

  27. Dulitzki M, Pauzner R, Langevitz P, et al. Low-molecular-weight heparin during pregnancy and delivery: preliminary experience with 41 pregnancies. Obstet Gynecol 1996; 87: 380–3

    Article  PubMed  CAS  Google Scholar 

  28. Hunt B, Doughty HA, Majumdar G, et al. Thrombo-prophylaxis with low molecular weight heparin (Fragmin) in high risk pregnancies. Thromb Haemost 1997; 77: 39–43

    PubMed  CAS  Google Scholar 

  29. Blomback M, Bremme K, Hellgren M, et al. Thromboprophylaxis with low molecular mass heparin, ‘Fragmin’ (dalteparin), during pregnancy: a longitudinal safety study. Blood Coagul Fibrinol 1998; 9: 1–9

    Article  CAS  Google Scholar 

  30. Pettila V, Kaaja R, Leinonen P, et al. Thromboprophylaxis with low molecular weight heparin (dalteparin) in pregnancy. Thromb Res 1999; 96: 275–82

    Article  PubMed  CAS  Google Scholar 

  31. Shefras J, Farquharson RG. Bone density studies in pregnant women receiving heparin. Eur J Obstet Gynecol Reprod Biol 1996; 65: 171–4

    Article  PubMed  CAS  Google Scholar 

  32. Rasmussen C, Wadt J, Jacobsen B. Thromboembolic prophylaxis with low molecular weight heparin during pregnancy. Int J Gynaecol Obstet 1994; 47: 121–5

    Article  PubMed  CAS  Google Scholar 

  33. Lima F, Khamashta MA, Buchanan NM, et al. A study of sixty pregnancies in patients with the antiphospholipid syndrome. Clin Exp Rheumatol 1996; 14: 131–6

    PubMed  CAS  Google Scholar 

  34. Wahlberg TB, Kher A. Low molecular weight heparin as thromboprophylaxis in pregnancy [letter]. Haemostasis 1994; 24: 55–6

    PubMed  CAS  Google Scholar 

  35. Granger KA, Farquharson RG. Obstetric outcome in antiphospholipid syndrome. Lupus 1997; 6: 509–13

    Article  PubMed  CAS  Google Scholar 

  36. Amout J, Spitz B, Wittevrongel C, et al. High-dose intravenous immunoglobulin treatment of a pregnant patient with an antiphospholipid syndrome: immunological changes associated with a successful outcome. Thromb Haemost 1994; 71: 741–7

    Google Scholar 

  37. Phillips JK, Majumdar G, Hunt BJ, et al. Heparin-induced skin reaction due to two different preparations of low molecular weight heparin (LMWH). Br J Haematol 1993; 84: 349–50

    Article  PubMed  CAS  Google Scholar 

  38. Gillis S, Shushan A, Eldor A. Use of low molecular weight heparin for prophylaxis and treatment of thromboembolism in pregnancy. Int J Gynaecol Obstet 1992; 39: 297–301

    Article  PubMed  CAS  Google Scholar 

  39. Nelson-Piercy C, Letsky EA, de Swiet M. Low-molecular-weight heparin for obstetric thromboprophylaxis: experience of sixty-nine pregnancies in sixty-one women at high risk. Am J Obstet Gynecol 1997; 176: 1062–8

    Article  PubMed  CAS  Google Scholar 

  40. Barjot P, Beucher G, Le Querrec A, et al. Resistance to activated protein C and pregnancy: thromboprophylaxis with low molecular weight heparin [in French]. J Gynecol Obstet Biol Reprod (Paris) 1999; 28(6): 544–9

    CAS  Google Scholar 

  41. Brenner B, Hoffman R, Blumenfeld Z, et al. Gestational outcome in thrombophilic women with recurrent pregnancy loss treated by enoxaparin. Thromb Haemost 2000; 83(5): 693–7

    PubMed  CAS  Google Scholar 

  42. Brennard J, Walker I, Greer I. Anti-activated factor Xa profiles in pregnant women receiving antenatal thromboprophylaxis with enoxaparin. Acta Haematol 1999; 101: 53–5

    Article  Google Scholar 

  43. Bar J, Cohen-Sacher B, Hod M, et al. Low-molecular-weight heparin for thrombophilia in pregnant women. Int J Gynaecol Obstet 2000; 69(3): 209–13

    Article  PubMed  CAS  Google Scholar 

  44. Ellison J, Walker ID, Greer IA. Antenatal use of enoxaparin for prevention and treatement of thromboembolism in pregnancy. BJOG 2000; 107(9): 1116–21

    Article  PubMed  CAS  Google Scholar 

  45. Thomson AJ, Walker ID, Greer IA. Low-molecular-weight heparin for immediate management of thromboembolic disease in pregnancy [letter]. Lancet 1998; 352: 1904

    Article  PubMed  CAS  Google Scholar 

  46. Gris JC, Neveu S, Tailand ML, et al. Use of a low-molecular weight heparin (enoxaparin) or of a phenformin-like substance (moroxydine chloride) in primary early recurrent aborters with an impaired fibrinolytic capacity. Thromb Haemost 1995; 73: 362–7

    PubMed  CAS  Google Scholar 

  47. Funai EF, Klein SA, Lockwood CJ. Successful pregnancy outcome in a patient with both congenital hypofibrinogenemia and protein S deficiency [abstract]. Obstet Gynecol 1997; 89: 858

    Article  PubMed  CAS  Google Scholar 

  48. Finkelstein Y, Aloni D, Kimia A, et al. Deep venous thrombosis in a preterm newborn of a mother with activated protein C resistance. Clin Pediatr (Phila) 1998; 37: 373–6

    Article  CAS  Google Scholar 

  49. Schneider DM, von Tempelhoff G-F, Heilmann L. Retrospective evaluation of the safety and efficacy of low-molecular-weight heparin as thromboprophylaxis during pregnancy [letter]. Am J Obstet Gynecol 1997; 177: 1567–8

    Article  PubMed  CAS  Google Scholar 

  50. Boda Z, Laszlo P, Rejto L, et al. Low molecular weight heparin as thromboprophylaxis in familial thrombophilia during the whole period of pregnancy [letter]. Thromb Haemost 1996; 76: 124–8

    Google Scholar 

  51. Lemesle F, Mebroukine L, Ermacora P, et al. Thrombose, thrombopénie sous HBPM et délivrance [letter]. Press Med 1998; 27(1): 19

    CAS  Google Scholar 

  52. Riyazi N, Leeda M, de Vries JI, et al. Low-molecular-weight heparin combined with aspirin in pregnant women with thrombophilia and a history of preeclampsia or fetal growth restriction: a preliminary study. Eur J Obstet Gynecol Reprod Biol 1998; 80: 49–54

    Article  PubMed  CAS  Google Scholar 

  53. Daskalakis G, Antsaklis A, Papageorgiou I, et al. Thrombosis prophylaxis after treatment during pregnancy. Eur J Obstet Gynecol 1997; 74: 165–7

    Article  CAS  Google Scholar 

  54. Shiozaki A, Arai T, Izumi R. Congenital antithrombin III deficient neonate treated with antithrombin III concentrates. Thromb Res 1993; 70: 211–6

    Article  PubMed  CAS  Google Scholar 

  55. Crowther M, Spitzer K, Julian J, et al. Pharmacokinetic profile of a low-molecular weight heparin (reviparin) in pregnant patients: a prospective cohort study. Thromb Res 2000; 98: 133–8

    Article  PubMed  CAS  Google Scholar 

  56. Macklon NS, Greer IA, Reid AW, et al. Thrombocytopenia, antithrombin deficiency and extensive thromboembolism in pregnancy: treatment with low-molecular-weight heparin. Blood Coagul Fibrinolysis 1995; 6: 672–5

    Article  PubMed  CAS  Google Scholar 

  57. Laifer SA, Stiller RJ, Dunston-Boone G, et al. Low-molecular-weight heparin for treatment of pulmonary embolism in a pregnant woman [letter]. Thromb Haemost 1999; 82(4): 1361–2

    PubMed  CAS  Google Scholar 

  58. Stephan D, Welsh M, Chapatte D, et al. Deep venous thrombosis during pregnancy: long-term treatment with low molecular weight heparin [in French] [letter]. Presse Med 1999; 28(34): 1880

    PubMed  CAS  Google Scholar 

  59. Henny CP, ten Cate H, ten Cate JW, et al. Thrombosis prophylaxis in an AT III deficient woman: application of a low molecular weight heparinoid [letter]. Thromb Haemost 1986; 55: 301

    PubMed  CAS  Google Scholar 

  60. Anand SS, Brimble S, Ginsberg JS. Management of iliofemoral thrombosis in a pregnant patient with heparin resistance. Arch Intern Med 1997; 157: 815–6

    Article  PubMed  CAS  Google Scholar 

  61. Rowlands S, Lahoud R, Hertzberg M, et al. Thromboembolism treated with low molecular weight heparin in a pregnancy complicated by major placenta praevia: a case report. J Obstet Gynaecol Res 1997; 23: 205–8

    PubMed  CAS  Google Scholar 

  62. Tam WH, Wong KS, Yuen PM, et al. Low-molecular-weight heparin and thromboembolism in pregnancy [letter]. Lancet 1999, 353: 932

    Article  PubMed  CAS  Google Scholar 

  63. Priollet P, Roncato M, Alach M, et al. Low-molecular weight heparin in venous thrombosis during pregnancy [letter]. Br J Haematol 1986; 63: 605–6

    Article  PubMed  CAS  Google Scholar 

  64. de Boer K, Heyboer H, ten Cate JW, et al. Low molecular weight heparin treatment in a pregnant woman with allergy to standard heparins and heparinoid [letter]. Thromb Haemost 1989; 61: 148

    PubMed  Google Scholar 

  65. Manoharan A. Use of low molecular weight heparin during pregnancy [letter]. J Clin Pathol 1994; 47: 94–5

    Article  PubMed  CAS  Google Scholar 

  66. Borel-Derlon A, Borg JY, Boudignat O, et al. Assessment of a low molecular weight heparin (enoxaparin) safety during pregnancy: a retrospective study of 624 pregnancies [abstract]. Thromb Haemost 1999; Suppl.: 491

  67. Conard J, Horellou MH, Van Dreden P., et al. Thrombosis and pregnancy in congenital deficiencies in AT III, protein C or protein S: Study of 78 women. Thromb Haemost 1990; 63: 319–20

    PubMed  CAS  Google Scholar 

  68. Pabinger I, Scheinder B. Thrombotic risk in hereditary antithrombin III, protein C and protein S deficiency. Arterioscl Thromb Vasc Biol 1996; 16: 742–8

    Article  PubMed  CAS  Google Scholar 

  69. McColl M, Ransay JE, Tait RC, et al. Risk factors for pregnancy associated venous thromboembolism. Thromb Haemost 1997; 78: 1183–8

    PubMed  CAS  Google Scholar 

  70. Sorensen HT, Johnsen SP, Larsen H, et al. Birth outcomes in pregnant women treated with low-molecular-weight heparin. Acta Obstet Gynecol Scand 2000; 79: 655–9

    PubMed  CAS  Google Scholar 

  71. Leizorovicz A, Simonneau G, Decousus H, et al. Comparison of efficacy and safety of low molecular weight heparins and unfractionated heparin in initial treatment of deep vein thrombosis: a meta-analysis. BMJ 1994; 309: 299–304

    Article  PubMed  CAS  Google Scholar 

  72. Lensing AWA, Prins MH, Davidson BL, et al. Treatment of deep venous thrombosis with low molecular weight heparins: a meta-analysis. Arch Intern Med 1995; 155: 601–7

    Article  PubMed  CAS  Google Scholar 

  73. Siragusa S, Cosmi B, Piovella F, et al. low-molecular-weight heparins and unfractionated heparin in the treatment of patients with acute venous thromboembolism: results of a metaanalysis Am J Med 1996; 100: 269–277

    Article  PubMed  CAS  Google Scholar 

  74. Dahlman TC. Osteoporotic fractures and recurrence of thromboembolism during pregnancy and the puerperium in 184 women undergoing thromboprophylaxis with heparin. Am J Obstet Gynecol 1993; 168: 1265–70

    PubMed  CAS  Google Scholar 

  75. Casele H, Laifer S. Prospective evaluation of bone density changes in pregnant women on low molecular weight heparin [abstract]. Am J Obstet Gynecol 1998; 178: 65S

    Google Scholar 

  76. Sanson BJ, Lensing AW, Prins MH, et al. Safety of low-molecular-weight heparin in pregnancy: a systematic review. Thromb Haemost 1999; 81: 668–72

    PubMed  CAS  Google Scholar 

  77. Forestier F, Sole Y, Aiach M, et al. Absence of transplacental passage of Fragmin (Kabi) during the second and third trimesters of pregnancy [letter]. Thromb Haemost 1992; 67: 180–1

    PubMed  CAS  Google Scholar 

  78. Saivin S, Giroux M, Dumas JC, et al. Placenta transfer of glycosaminoglycans in the human perfused placenta cotyledon model. Eur J Obstet Gynecol Reprod Biol 1991; 42: 221–5

    Article  PubMed  CAS  Google Scholar 

  79. Ginsberg JS, Hirsh J. Use of antithrombotic agents during pregnancy. Chest 1998; 114: 524S–30S

    Article  PubMed  CAS  Google Scholar 

  80. Hirsh J, Warkentin TE, Raschke R, et al. Heparin and low molecular weight heparin: mechanisms of action, pharmacokinetics, dosing considerations, monitoring, efficacy, and safety. Chest 1998; 114: 480S–510S

    Article  Google Scholar 

  81. Nelson-Piercy C. Hazards of heparin: allergy, heparin induced thrombocytopenia and osteoporosis. Baillieres Clin Obstet Gyneacol 1997; 11: 489–509

    Article  CAS  Google Scholar 

  82. Casele HL, Laifer SA. Prospective evaluation of bone density in pregnant women receiving the low molecular weight heparin enoxaparin sodium. J Matern Fetal Med 2000; 9(2): 122–5

    Article  PubMed  CAS  Google Scholar 

  83. Weitz JI. Low-molecular-weight heparins. N Engl J Med 1997; 337: 688–98

    Article  PubMed  CAS  Google Scholar 

  84. Lecompte T, Luo SK, Stieltjes N, et al. Thrombocytopenia associated with low molecular weight heparin [abstract]. Lancet 1991; 338: 1217

    Article  Google Scholar 

  85. Horlocker TT, Heit JA. Low molecular weight heparin: biochemistry, pharmacology, perioperative prophylaxis regimens, and guidelines for regional anesthetic management. Anesth Analg 1997; 85: 874–85

    PubMed  CAS  Google Scholar 

  86. Letsky E. Peripartum prophylaxis of thromboembolism. In: Greer IA, editor. Bailliere’s clinical obstetrics and gynaecology. Thromboembolic disease in obstetrics and gynaecology. London: Bailliere Tindall, 1997: 523–543

    Google Scholar 

  87. Kessler CM. Low molecular weight heparins: practical considerations. Semin Hematol 1997; 34: 35–42

    PubMed  CAS  Google Scholar 

  88. Chan WS, Ray JG. Low molecular weight heparin use during pregnancy: issues of safety and practicality. Obstet Gynecol Surv 1999; 54(10): 649–54

    Article  PubMed  CAS  Google Scholar 

  89. Wehrmacher WH, Karlman RL, Scanion P, et al. Anticoagulant therapy of thromboembolic disease during pregnancy. Comp Ther 1998; 24(6/7): 289–94

    CAS  Google Scholar 

  90. Demers C, Ginsberg JS. Deep venous thrombosis and pulmonary embolism in pregnancy. Clin Chest Med 1992; 13(4): 645–56

    PubMed  CAS  Google Scholar 

  91. Casele HL, Laifer SA, Woelkers DA, et al. Changes in the pharmacokinetics of the low-molecular-weight heparin enoxaparin sodium during pregnancy. Am J Obstet Gynecol 1999; 181: 1113–7

    Article  PubMed  CAS  Google Scholar 

  92. Nelson-Piercy C. Prevention of thromboembolism in pregnancy. Scand J Rheumatol 1998; 27 Suppl. 107: 92–6

    Google Scholar 

  93. Heilmann L, Schneider DM, von Tempelhoff GF. Antithrombotic therapy in high-risk pregnancy. Hematol Oncol Clin North Am 2000 Oct; 14(5): 1133–50

    Article  PubMed  CAS  Google Scholar 

  94. Lee LH, Liauw PC. Low molecular weight heparin for thromboprophylaxis during pregnancy in two patients with mitral valve replacement. Thromb Haemost 1996; 76: 627–31

    Google Scholar 

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Acknowledgements

We would like to express our gratitude to Mathilde Himji for her assistance with the bibliography. No funding was received for the preparation of this article.

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Laurent, P., Dussarat, GV., Bonal, J. et al. Low Molecular Weight Heparins. Drugs 62, 463–477 (2002). https://doi.org/10.2165/00003495-200262030-00004

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