When should heparin be discontinued before a scheduled induction or cesarean section?

Heparin, an anticoagulant medication, is important in preventing thromboembolic events, especially in certain populations during pregnancy. However, when planning for a scheduled induction or cesarean section, the risk of bleeding during and after the procedure increases when anticoagulants are present in the system.

The appropriate timing for discontinuation of heparin is 24 hours before the scheduled procedure. This interval allows sufficient time for the anticoagulant effects of heparin to diminish safely, thus reducing the risk of excessive bleeding during surgical interventions. The pharmacokinetics of heparin indicate that, after this period, the majority of its anticoagulation effect will have waned, minimizing complications related to its use.

In contrast, the other timings suggested do not provide an adequate window for the heparin's effects to be sufficiently reduced before the surgical or induction process. For instance, discontinuing heparin 12 hours prior may not be enough time for the drug to clear from the system, leaving a potential risk for increased bleeding. Similarly, stopping heparin 48 hours before may be unnecessarily cautious in many cases, which could lead to a higher risk of thromboembolic events if the heparin is needed for