OB Anticoagulation Guidelines

Below is a table drafted from combined SOAP consensus Statement as well as ASRA Coags 2.1

SQH

UFH SQ up to 5000U TID

Low dose	Hold
Pre-placement	4-6h
After placement	immediate
Pre-removal	4-6h
After removal	immediate

UFH SQ up to 10,000U BID

Intermediate dose	Hold
Pre-placement	12h & aPTT
After placement	1h
Pre-removal	4-6h
After removal	immediate

UFH SQ >20,000U total daily

High Dose	Hold
Pre-placement	24h & aPTT
After placement	1h
Pre-removal	Not advised
After removal	immediate

LMWH

Enoxaparin SQ - 40mg QD or 30mg BID

Low Dose	Hold
Pre-placement	12h
After placement	12h
Pre-removal	Not advised
After removal	4h AND >12h from placement

Enoxaparin SQ - 1.5mg/kg QD or 1.0mg/kg BID

Low Dose	Hold
Pre-placement	24h
After placement	24h
Pre-removal	Not advised
After removal	4h AND >24h from placement

All

Drug	Dose	Pre-placement	After placement	Pre-removal	After removal
SQH	5000 TID	4-6h	immediate	4-6h	immediate
SQH - Hi	7500 BID	12h & aPTT	1h	4-6h	immediate
LMWH - Lo	40mg QD 30mg BID	12h	12h	not advised	4h if 12h after placement
LMWH - Md	<1.5mg/kg QD <1.0mg/kg BID	12-24h	12-24h	not advised	4h AND 12h after placement
LMWH - Hi	1.5mg/kg QD 1.0mg/kg BID	24h	24h	not advised	4h AND 12h after placement
ASA + SQH ASA + LMWH		24h		Can resume ASA	24h