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Pregnancy-Related Thromboembolism
- Martin H. Prins, MD, PhD
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IN RESPONSE:
Dr. Manoharan addresses the important issue of the use of a drug when there is no formal knowledge of safety in a specific situation. The experience with low-molecular-weight heparin in pregnancy was obtained while the pharmaceutical companies advised against use of the drug during pregnancy [1, 2]. One report has indicated that low-molecular-weight heparin, like unfractionated heparin, does not appear in breast milk [3]. Moreover, heparin is not easily absorbed and thus when given orally is unlikely to cause any adverse effects.
We thank Brickner and colleagues for pointing out a mathematical error that escaped our attention when we reviewed the galley proofs of our article. The numbers in the second paragraph of the introduction should read 0.018%, 0.013% to 0.07%, and 0.061% to 0.23%, respectively. Thus, Brickner and colleagues' findings agree with the existing literature on the incidence of pregnancy-related venous thromboembolism in the general population.
Martin H. Prins, MD, PhD
Academic Medical Center, University of Amsterdam; Amsterdam, the Netherlands
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
