Obstetrical Management of an Extremely Overweight Pregnant Woman (184 kg bw) with Special Attention on Thromboprophylaxis

Table 1

Pre-, peri-, and postoperative days the examine and follow the efficiency of heparin therapy by monitoring of anti-Xa activity.

Days	Sd. 38; Day 6	Opus; Day 1*	Opus; Day 0**	Postop.; Hour 6	Postop.; Day 2	Puerp.; Day 6	Puerp.; Day 32***	Puerp.; Day 40
MWH (Clexane) mg	2 × 160	2 × 180	2 × 200	2 × 200	2 × 200	2 × 200	2 × 220	2 × 200
Heparin level IU/mL aXf.****	0.01	0.45	0.45	0.45	0.55	0.55	0.20	0.60
Comment	Hospital admission	Perioperative period			Self-administer bid	Infection	Faulty heparin measurement	Recovery

∗Due to the extremely robust abdominal wall the patient was administered heparin into the subcutaneous region of her shoulder for better absorption.
**At time of performing caesarean section.
***The patient self-administered heparin later (she fell asleep) and measurement occurred 2 h after administer LMWH.
****The target was to achieve at least 0.5 anti-Xa activity four hours after injection.