Short Review| Volume 207, P58-61, November 2021

Challenging anticoagulation cases: A case of heparin-induced-thrombocytopenia in the first trimester of pregnancy

Published:September 13, 2021DOI:


      • Heparin-induced thrombocytopenia (HIT) in pregnancy, especially in the first trimester, is uncommon
      • Fondaparinux is a reasonable anticoagulation option for HIT in pregnancy
      • Duration of therapeutic anticoagulation for provoked emboli in pregnancy is unclear
      • Involvement of a tertiary center for anticoagulation and obstetrical management for pregnant patients with HIT is recommended


      Heparin-induced thrombocytopenia in pregnancy is an uncommon phenomenon which rarely occurs in the first trimester. Therapeutic options and duration of therapeutic anticoagulation are varied amongst reported published cases. We report a 41-year-old female with confirmed HIT following anticoagulation with dalteparin for deep vein thrombosis (DVT). She was treated with therapeutic fondaparinux for 3 months followed by prophylaxis dosage until delivery and for 6 weeks thereafter. A review of reported cases of the development of HIT in the first trimester and subsequent clinical management is discussed.


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