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The antithrombotic drug of choice during pregnancy should be heparin, even taking into consideration the fact that long-term (6 months or more) application of heparin can cause severe osteoporosis in the mother. To minimize the risk of osteoporosis heparin is given in the first trimester, following by coumarin therapy until about the 36th week, and then heparin is given for the last few weeks. Heparin therapy should be completely stopped six hours before delivery.
Heparin does not cross the placental barrier and is not secreted into breast milk.
