Which anticoagulant is contraindicated in pregnancy?

Which anticoagulant is contraindicated in pregnancy?

• A. Warfarin
• B. Heparin
• C. Enoxaparin
• D. Dabigatran

Answer: (D)

In pregnancy, the choice of anticoagulant centers on fetal safety and whether the drug crosses the placenta. Dabigatran is a direct oral anticoagulant whose safety in pregnancy is not established, and it can cross the placenta, raising potential fetal bleeding and developmental risks. Because of these concerns, it is contraindicated during pregnancy. By contrast, heparin and enoxaparin are large molecules that do not cross the placenta in meaningful amounts, so they are routinely used for anticoagulation in pregnancy. Warfarin, while effective, is known to be teratogenic and can cause fetal malformations and bleeding, so it is generally avoided in pregnancy except in rare, highly specific scenarios where benefits outweigh risks.

In pregnancy, the choice of anticoagulant centers on fetal safety and whether the drug crosses the placenta. Dabigatran is a direct oral anticoagulant whose safety in pregnancy is not established, and it can cross the placenta, raising potential fetal bleeding and developmental risks. Because of these concerns, it is contraindicated during pregnancy.

By contrast, heparin and enoxaparin are large molecules that do not cross the placenta in meaningful amounts, so they are routinely used for anticoagulation in pregnancy. Warfarin, while effective, is known to be teratogenic and can cause fetal malformations and bleeding, so it is generally avoided in pregnancy except in rare, highly specific scenarios where benefits outweigh risks.