Anticoagulant of choice in pregnancy

Ref: KD Tripathi, 6th ed. pg. 597* Heparin is a powerful and instantaneously acting anticoagulant, effective both in vivo and in vitro.* It acts indirectly by activating plasma antithrombin III* The heparin -AT III complex then binds to clotting factors of the intrinsic and common pathways (Xa, IIa, IXa, XIa, XIIa and XIIIa) and inactivates them.* Heparin is the anticoagulant of choice in pregnancy* Warfarin on the other hand is effective only in vivo (body). It acts by inhibiting vitamin K.Heparin is monitored by aPTTLow molecular heparin inhibits factor Xa only. It does not require monitoring because of consistent bioavailability.Antidote for heparin overdose: Protamine Sulfate.Warfarin monitoring is done by: INRAntidote of warfarin overdose: Vitamin K.TOC for warfarin induced bleeding: FFP