2022
The relationship between INTEM/HEPTEM coagulation time ratio and heparin plasma concentration in obstetric patients: an exploratory in vitro investigation
Katz D, Leffert L, Getrajdman C, Sison M, Shin DW, Lin HM, Butwick A. The relationship between INTEM/HEPTEM coagulation time ratio and heparin plasma concentration in obstetric patients: an exploratory in vitro investigation. Journal Canadien D'anesthésie 2022, 69: 597-604. PMID: 35102496, DOI: 10.1007/s12630-022-02193-5.Peer-Reviewed Original ResearchMeSH KeywordsAnticoagulantsBlood CoagulationBlood Coagulation TestsHeparinHumansVenous ThromboembolismConceptsObstetric patientsUnfractionated heparinConcentration of heparinHeparin activityHeparin concentrationPartial thromboplastin time (aPTT) testingCT ratioCare coagulation testsHeparin plasma concentrationsResultsSeventy-seven patientsPartial thromboplastin timeUncomplicated pregnanciesThird trimesterNeuraxial anestheticPlasma concentrationsCoagulation testsThromboplastin timeBlood samplesPatientsHeparinAPTTHematocrit rangeVitro investigationBloodTime ratio
2019
Don’t throw the baby out with the bathwater: spinal-epidural hematoma in the setting of obstetric thromboprophylaxis and neuraxial anesthesia
Leffert L, Horlocker T, Landau R. Don’t throw the baby out with the bathwater: spinal-epidural hematoma in the setting of obstetric thromboprophylaxis and neuraxial anesthesia. International Journal Of Obstetric Anesthesia 2019, 39: 7-11. PMID: 31202587, DOI: 10.1016/j.ijoa.2019.05.001.Peer-Reviewed Original Research
2018
The Society for Obstetric Anesthesia and Perinatology Consensus Statement on the Anesthetic Management of Pregnant and Postpartum Women Receiving Thromboprophylaxis or Higher Dose Anticoagulants
Leffert L, Butwick A, Carvalho B, Arendt K, Bates SM, Friedman A, Horlocker T, Houle T, Landau R, Dubois H, Fernando R, Houle T, Kopp S, Montgomery D, Pellegrini J, Smiley R, Toledo P. The Society for Obstetric Anesthesia and Perinatology Consensus Statement on the Anesthetic Management of Pregnant and Postpartum Women Receiving Thromboprophylaxis or Higher Dose Anticoagulants. Anesthesia & Analgesia 2018, 126: 928-944. PMID: 29099429, DOI: 10.1213/ane.0000000000002530.Peer-Reviewed Original ResearchConceptsHigh-dose anticoagulantsConsensus statementMaternal deathsObstetric anesthesiaNeuraxial proceduresPerinatology Consensus StatementPharmacodynamics of anticoagulantsUse of thromboprophylaxisRisk-benefit discussionsKey preventive measuresObstetric populationObstetric surgeryCesarean deliveryNeuraxial analgesiaVenous thromboembolismAnesthetic managementObstetric patientsDifficult airwayNeuraxial anesthesiaGeneral anesthesiaPostpartum womenPregnant womenFetal harmPostpartum periodLeading cause
2017
Canadian stroke best practice consensus statement: Secondary stroke prevention during pregnancy
Swartz RH, Ladhani NNN, Foley N, Nerenberg K, Bal S, Barrett J, Bushnell C, Chan WS, Chari R, Dowlatshahi D, Amrani ME, Gandhi S, Gubitz G, Hill MD, James A, Jeerakathil T, Jin A, Kirton A, Lanthier S, Lausman A, Leffert LR, Mandzia J, Menon B, Pikula A, Poppe A, Potts J, Ray J, Saposnik G, Sharma M, Smith EE, Bhogal S, Smitko E, Lindsay MP. Canadian stroke best practice consensus statement: Secondary stroke prevention during pregnancy. International Journal Of Stroke 2017, 13: 406-419. PMID: 29171360, DOI: 10.1177/1747493017743801.Peer-Reviewed Original ResearchMeSH KeywordsAnticoagulantsAntihypertensive AgentsCanadaCounselingDiabetes, GestationalDiabetic AngiopathiesFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsHypertensionIschemic Attack, TransientPlatelet Aggregation InhibitorsPostnatal CarePreconception CarePregnancyPregnancy Complications, CardiovascularPregnancy in DiabeticsPrenatal CareProfessional PracticeRisk FactorsSecondary PreventionStrokeConceptsSecondary stroke preventionStroke preventionConsensus statementUse of antithromboticsTransient ischemic attackBlood pressure managementIschemic stroke etiologyAspects of pregnancyHealth care professionalsGeneral management considerationsBest available literatureIschemic attackRecurrent strokeLipid managementStroke etiologyStroke riskFetal healthMaternal healthPrior historyFetal wellbeingCare professionalsClinical considerationsPregnancyConsensus documentExpert consensusNeuraxial Anesthesia in Obstetric Patients Receiving Thromboprophylaxis With Unfractionated or Low-Molecular-Weight Heparin
Leffert LR, Dubois HM, Butwick AJ, Carvalho B, Houle TT, Landau R. Neuraxial Anesthesia in Obstetric Patients Receiving Thromboprophylaxis With Unfractionated or Low-Molecular-Weight Heparin. Anesthesia & Analgesia 2017, 125: 223-231. PMID: 28628578, DOI: 10.1213/ane.0000000000002173.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAnesthesia, ConductionAnesthesia, ObstetricalAnesthesiologyAnestheticsAnticoagulantsCesarean SectionDelivery, ObstetricFemaleHematoma, Epidural, SpinalHeparinHeparin, Low-Molecular-WeightHumansMiddle AgedNerve BlockPregnancyPregnancy Complications, CardiovascularThrombosisYoung AdultConceptsSpinal epidural hematomaCases of SEHNeuraxial anesthesiaObstetric patientsVenous thromboembolismWeight heparinAnesthesia Closed Claims Project databaseSystematic reviewPractice changePostpartum venous thromboembolismVaginal delivery hospitalizationsWeight heparin doseRisk of thromboembolismLarge-scale registriesMajority of womenEnglish-language studiesAnticoagulated womenDelivery hospitalizationsPharmacological thromboprophylaxisAnticoagulant doseCesarean deliveryEpidural hematomaHeparin doseVaginal deliveryGeneral anesthesia