Plasma and milk concentrations of acenocoumarin in breast-feeding women during post partum
Nava, L.E.R.; Gómez, A.B.; González, V.M.V.
Ginecologia y Obstetricia de Mexico 72: 550-560
2004
ISSN/ISBN: 0300-9041 PMID: 15986763 Document Number: 570463
Patients are receiving anticoagulants during postpartum. Literature data still is controversy in milk excretion of acenocoumarin; there are conducts in favor and against. Because of the benefits of maternal milk it's necessary to probe if acenocoumarin is excreted by human milk. To determine the milk excretion of acenocoumarin in different periods of the postpartum and the milk excretion index in anticoagulant women. It's an observational, descriptive and prospective study. The milk and plasma concentrations of acenocoumarin were determined in breast-feeding mothers with anticoagulation during the postpartum. ANOVA was used to determine the differences in pharmacokinetic constants in the different days of study. Two patients required light anticoagulation, nine moderate and five intense. The 37.5% of the new born were full term hypotrophy and the 18.75% were preterm. The highest plasma average concentration of acenocoumarin was found in day 45th postpartum (0.21 microg/mL). Acenocoumarin present in milk was found until day 30th; the average concentrations were low 0.011 microg/mL. The value of the maternal milk excretion index was 0.057 in day 45, what represents that approximately the 5% of acenocoumarin is eliminated by milk. The calculated dose of acenocoumarin that a new born could receive through maternal milk was lower than the recommended doses (1.79 microg/kg/day). These results allowed us to recommend breastfeeding in patients who are been anticoagulated with acenocoumarin.