Evidence map›Paper›PMID 22315276›Full record

GuidelineChest2012

VTE, thrombophilia, antithrombotic therapy, and pregnancy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.

Shannon M Bates, Ian A Greer, Saskia Middeldorp, David L Veenstra, Anne-Marie Prabulos, Per Olav Vandvik

3 registry-linked trialsOpen access · bronzeAbstract readPractice Guideline
PubMed Full text at PMC Publisher
In one paragraph

Guideline in Chest, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 366 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
366citing papers in PubMed, 12 pooled it
67.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01828697 phase4completednot on this mapstarted 2013, after this paper: background citation

Low-molecular-weight Heparin to Prevent Recurrent VTE in Pregnancy: a Randomized Controlled Trial of Two Doses

TypeinterventionalSponsorAcademisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)Ran2013 to 2021Enrolled1,110ConditionsDeep Venous Thrombosis, Pulmonary EmbolismArmsLow dose nadroparin, Intermediate dose nadroparin, Low dose enoxaparin, Intermediate dose enoxaparin, Low dose dalteparin
NCT02600260 nacompletednot on this mapstarted 2014, after this paper: background citation

Thromboprophylaxis in Pregnant Women in Hospital: A Prospective Clinical Trial

TypeinterventionalSponsorUniversity of Sao Paulo General HospitalRan2014 to 2019Enrolled7,212ConditionsThrombophilia Associated With Pregnancy, Perioperative/Postoperative Complications, Venous Thrombosis, Pulmonary EmbolismArmsEnoxaparin, No intervention
NCT02856295 phase4completednot on this mapstarted 2021, after this paper: background citation

anti10a Levels in Women Treated With LMWH in the Postpartum Period for Preventing Vein Thrombosis Events: A Comparison of Two Doses

TypeinterventionalSponsorHaEmek Medical Center, IsraelRan2021 to 2022Enrolled136ConditionsVenous ThromboembolismArmsclexane (LMWH)
3 · Its place in the literature

Who cites it

366 citing papers in PubMed, 12 syntheses or guidelines pooled it, 1,488 citations in OpenAlex.

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  18. Association of EndometrialBiomedicines · 2026
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306 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 6 institutions in 5 countries.

Shannon M BatesDepartment of Medicine, McMaster University and Thrombosis and Atherosclerosis Research Institute, Hamilton, ON, Canada. Electronic address: batesm@mcmaster.ca.
Ian A GreerFaculty of Health and Life Sciences, University of Liverpool, Liverpool, England.
Saskia MiddeldorpDepartment of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands.
David L VeenstraDepartment of Pharmacy, University of Washington, Seattle, WA.
Anne-Marie PrabulosDepartment of Obstetrics and Gynecology, University of Connecticut School of Medicine, Farmington, CT.
Per Olav VandvikMedical Department, Innlandet Hospital Trust and Norwegian Knowledge Centre for the Health Services, Gjøvik, Norway.
Academic Medical Center · NLMcMaster University · CANasjonalt Kunnskapssenter for Helsetjenesten · NOUniversity of Connecticut · USUniversity of Liverpool · GBUniversity of Washington · US

Funding

Antithrombotic Therapy and Prevention of Thrombosis: ACCP Evidence-Based ClinicalR13HL104758 · NHLBI · AMERICAN COLLEGE OF CHEST PHYSICIANS · PI LEWIS, SANDRA ZELMAN · 2010 to 2010
$11k
NHLBI NIH HHS R13 HL104758
6 · The paper itself

Abstract

backgroundThe use of anticoagulant therapy during pregnancy is challenging because of the potential for both fetal and maternal complications. This guideline focuses on the management of VTE and thrombophilia as well as the use of antithrombotic agents during pregnancy.

methodsThe methods of this guideline follow the Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines in this supplement.

resultsWe recommend low-molecular-weight heparin for the prevention and treatment of VTE in pregnant women instead of unfractionated heparin (Grade 1B). For pregnant women with acute VTE, we suggest that anticoagulants be continued for at least 6 weeks postpartum (for a minimum duration of therapy of 3 months) compared with shorter durations of treatment (Grade 2C). For women who fulfill the laboratory criteria for antiphospholipid antibody (APLA) syndrome and meet the clinical APLA criteria based on a history of three or more pregnancy losses, we recommend antepartum administration of prophylactic or intermediate-dose unfractionated heparin or prophylactic low-molecular-weight heparin combined with low-dose aspirin (75-100 mg/d) over no treatment (Grade 1B). For women with inherited thrombophilia and a history of pregnancy complications, we suggest not to use antithrombotic prophylaxis (Grade 2C). For women with two or more miscarriages but without APLA or thrombophilia, we recommend against antithrombotic prophylaxis (Grade 1B).

conclusionsMost recommendations in this guideline are based on observational studies and extrapolation from other populations. There is an urgent need for appropriately designed studies in this population.

Indexed as

Evidence-Based MedicineSocieties, MedicalAbortion, SpontaneousAnticoagulantsAntiphospholipid SyndromeDose-Response Relationship, DrugFemaleFibrinolytic AgentsHeparinHeparin, Low-Molecular-WeightHumansPregnancyPregnancy Complications, CardiovascularRisk FactorsSecondary PreventionThrombophiliaAnticoagulantsFibrinolytic AgentsHeparinHeparin, Low-Molecular-Weight

Identifiers

PMID22315276
PMCPMC3278054
OpenAlexW2142237458

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.