What anticoagulant is commonly used during pregnancy?

Heparin is the anticoagulant commonly used during pregnancy due to its safety profile and mechanism of action. Unlike warfarin, which crosses the placenta and can cause fetal harm, heparin is a large molecule that does not cross the placental barrier, making it a safer choice for pregnant patients requiring anticoagulation.

Heparin comes in two forms: unfractionated heparin and low molecular weight heparins (LMWH), such as enoxaparin. LMWH is particularly favored because it has a more predictable anticoagulant effect, can be administered subcutaneously, and has a lower risk of heparin-induced thrombocytopenia compared to unfractionated heparin.

Warfarin, while effective for venous thromboembolism in non-pregnant patients, poses serious risks during pregnancy, especially in the first trimester and around delivery, due to the potential for teratogenic effects and bleeding complications.

Rivaroxaban and apixaban, both direct oral anticoagulants, are contraindicated in pregnancy due to a lack of safety data and concerns about their effects on the developing fetus. Therefore, heparin remains the standard care for anticoagulation management in pregnant individuals.