Safety of Fondaparinux as Post Partum Thromboprophylaxis
Safety of Fondaparinux as Postpartum Venous Thromboembolism Prophylaxis
Venous thromboembolism (VTE) remains as one of leading causes of maternal morbidity and mortality, with postpartum period carries the greatest risk. Perinatal thromboprophylaxis is often administered based on risk-factor assessment. Low molecular weight heparin has a proven safety profile in obstetrics population, however its porcine derived content may lead to reduced uptake amongst certain religious groups. The investigators aimed to evaluate the safety of fondaparinux as an alternative postpartum thromboprophylaxis.
The investigators planned a prospective, single arm, open label study. Women who fulfilled the criteria for post natal thromboprophylaxis based on the 2015 RCOG guidelines were recruited. Each patient would receive subcutaneous injection of Fondaparinux, 2.5mg daily for 10 days. The investigators would conduct a telephone interview on day 10 post delivery and six week outpatient review in clinic.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
All women were taught the injection technique and counselled regarding the symptoms of bleeding and VTE, prior to discharge. All patients were also advised to wear compression stockings and ensure adequate hydration at home
The primary outcome measure was occurrence of pulmonary embolism or deep vein thrombosis suggestive by clinical symptoms and assessment. Secondary outcome measures were allergic reaction and bleeding tendency such as secondary post-partum haemorrhage, spinal site bleeding and wound haematoma. Allergic reaction and bleeding tendency in neonates were also recorded.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
Kuala Lumpur
-
Cheras, Kuala Lumpur, Malaysia, 56000
- Department of Obstetrics & Gynaecology, Universiti Kebangsaan Medical Centre
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Malaysian
- Age 18 and above
- Scores asintermediate risk on 2015 Royal College of Obstetricians & Gynaecologists (RCOG) VTE risk assessment
Exclusion Criteria:
- Hypersensitivity to fondaparinux
- Patients with bleeding disorders - haemophilia , thrombocytopenia, von Willebrand's disease.
- Weight < 50 kg
- Patients with primary postpartum haemorrhage
- Patients who already on anti - coagulants
- Medical co morbidities - Systemic lupus erythematosus, heart failure, nephrotic syndrome, type 1 diabetes mellitus with nephropathy, sickle cell disease, current intravenous drug user
- Uncontrolled hypertension ( blood pressure > 200 mmHg systolic or > 120 mmHg diastolic )
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Fondaparinux
Subcutaneous injection of fondaparinux 2.5 mg once daily would be given over 10 days for post partum thromboprophylaxis
|
post natal thromboprophylaxis
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Venous thromboembolism (VTE)
Time Frame: Within six weeks of delivery
|
VTE occurence of either deep vein thrombosis or pulmonary embolism
|
Within six weeks of delivery
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Major Bleeding requiring hospitalisation
Time Frame: within six weeks of delivery
|
Secondary post partum haemorrhage or spinal site bleeding
|
within six weeks of delivery
|
|
Minor bleeding
Time Frame: within six weeks of delivery
|
Wound site bleeding, skin bruising
|
within six weeks of delivery
|
|
Allergic reaction
Time Frame: within 24 hours from last injection
|
Any allergy symptoms following injection of fondaparinux
|
within 24 hours from last injection
|
|
Neonatal bleeding tendency
Time Frame: within six weeks of delivery
|
Any bruising of bleeding tendency in neonates
|
within six weeks of delivery
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Nor Azlin Mohamed Ismail, MBCHB, MMED, Faculty of Medicine, National University of Malaysia
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Cardiovascular Diseases
- Vascular Diseases
- Embolism and Thrombosis
- Thromboembolism
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Fibrinolytic Agents
- Fibrin Modulating Agents
- Protease Inhibitors
- Factor Xa Inhibitors
- Antithrombins
- Serine Proteinase Inhibitors
- Anticoagulants
- Fondaparinux
- PENTA
Other Study ID Numbers
Other Study ID Numbers
- JEP -2017-543
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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