HEPTEST: a suitable method for monitoring heparin during pregnancy
Authors: Campbell, P. J.1; Tirvengadum, M. A.1; Pickering, W.1; Cohen, H.2; Ryan, K. E.1
Source: Clinical & Laboratory Haematology, Volume 21, Number 3, June 1999 , pp. 193-200(8)
Publisher: Blackwell Publishing
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Abstract:
Methods of monitoring heparin in pregnancy are problematic. The aim of this study was to assess the plasma HEPTEST as a rapid and reliable test for heparin monitoring in pregnancy. HEPTEST, activated partial thromboplastin time (APTT) and chromogenic anti-Xa assays were performed on individual heparin-spiked plasma samples from two groups; normal non-pregnant women (n = 6) and normal pregnant women during the third trimester (n = 6). Heparin activity curves were established in plasma from both groups for low (<0.3 IU/ml), intermediate (0.3-0.7 IU/ml) and high (>0.7 IU/ml) heparin concentrations and validated by comparison with the anti-Xa chromogenic assay. Both the APTT and HEPTEST demonstrated good correlation with anti-Xa levels across all heparin concentrations in both plasma groups (r range = 0.879-0.945). In comparison with the APTT, the HEPTEST showed better correlation with anti-Xa levels at low concentrations of heparin (r values 0.933 vs 0.772, respectively). For both the APTT and HEPTEST there were significant differences between the clotting times in pregnant and non-pregnant plasma at a number of heparin concentrations. This data supports the plasma HEPTEST as an acceptable alternative to the chromogenic anti-Xa assay for monitoring heparin thromboprophylaxis in pregnancy.Keywords: APTT; heparin; HEPTEST; pregnancy; thromboprophylaxis
Document Type: Research article
DOI: 10.1046/j.1365-2257.1999.00208.x
Affiliations: 1: Department of Haematology, Central Middlesex Hospital and 2: St Mary's Hospital Medical School, London, UK
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