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Management of Venous Thromboembolism
- Amir Qaseem, MD, PhD, MHA; and
- Vincenza Snow, MD
IN RESPONSE:
Our recommendations are based on evidence from randomized, controlled trials only. That is why the studies that were mentioned in the letters comparing the efficacy of LMWH and unfractionated heparin, as well as for safety of heparin and warfarin during pregnancy, were not mentioned in the guideline. However, LMWH is more cost-effective than unfractionated heparin. Although many studies have evaluated prophylactic use of LMWH in pregnant women, the evidence is scarce for treating deep venous thrombosis or pulmonary embolism in pregnant women.
Amir Qaseem, MD, PhD, MHA
Vincenza Snow, MD
American College of Physicians
Philadelphia, PA 19106
Potential Financial Conflicts of Interest: None disclosed.
