Saturday, April 2, 2016

MKSAP: 32-year-old woman is evaluated for anticoagulation management

A 32-year-old woman is evaluated for anticoagulation management after an uncomplicated vaginal delivery of a healthy newborn. She was diagnosed with a bilateral pulmonary embolism at 25 weeks’ gestation and was treated with therapeutic low-molecular-weight heparin (LMWH). The LMWH was discontinued at the onset of labor and was restarted 6 hours after delivery. Medical history is otherwise unremarkable, and her only medication is full-dose LMWH.

Anticoagulation for 3 months is planned. The patient wishes to breastfeed her newborn.

Which of the following is the most appropriate anticoagulation option for this patient?

A: Apixaban
B: Dabigatran
C: Fondaparinux
D: Rivaroxaban
E: Warfarin

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