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Many practitioners consider low-molecular-weight heparin (LMWH) an alternative to unfractionated heparin, although there are limited safety data regarding maternal and fetal outcomes in patients using an LMWH during pregnancy. A retrospective chart review was performed on 72 patients with thrombophilia exposed to the LMWH, enoxaparin, during pregnancy. Eighty-five pregnancies resulted in 93 of 99 potential live births. Eleven of 12 twin pregnancies and one triplet pregnancy were successful. One preterm live birth infant of 33 weeks' gestation did not survive. Three patients with thrombophilia spontaneously aborted. A patient receiving injectable fertility treatment had spontaneously aborted one twin at 5 weeks' gestation. One patient terminated the pregnancy after discovering the presence of Down's syndrome. The mean maximum dose required to achieve a therapeutic anti-Xa level of 0.2-0.4 IU/mL at 5 to 6 hours following administration, was 38.1 mg every 12 hours (median 35 mg, range 30-75 mg every 12 hours). The mean anti-Xa level was 0.28 IU/mL (median 0.3, range 0.05-0.8 IU/mL). A total of nine patients experienced bleeding events, two requiring discontinuation of enoxaparin for the remainder of the pregnancy. Two patients experienced injection site reactions requiring discontinuation of enoxaparin. Three patients developed preeclampsia, two placenta abruptio, and one placenta previa. No thromboembolic complications or osteoporotic fractures had occurred. Enoxaparin was safe and effective for preventing thromboembolism and adverse obstetrical complications in our patients, including 12 of 13 multiple gestation pregnancies.

Background. Midwestern University College of Pharmacy-Glendale in Glendale, Arizona, offers an elective course in advanced cardiac life support (ACLS), allowing students to obtain certification. Teaching methods, course format, and student feedback, along with the results of a telephone survey of all accredited colleges of pharmacy, are reported. Methods. Teaching formats include traditional lectures, student role-playing, and hands-on activities. Students evaluated the course upon completion. Colleges of pharmacy were contacted by telephone to determine whether ACLS certification is offered to their students. Results. Student feedback was positive and indicated a high value for the teaching formats used. To date, 176 of 178 students have successfully achieved certification. Of the 86 colleges of pharmacy surveyed, only one other college offers an ACLS certification course. Conclusions. This course provided students with the knowledge and skills to obtain ACLS certification by integrating curriculum information with application activities that enhanced student learning. Only one other college of pharmacy offers ACLS certification.

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