Fatwa on Clexane and Fraxiparine which are used for Venous Thromboembolism (VTE) during pregnancy and puerperium, imposed by the Malaysian National Fatwa Council (MNFC) in 2009 stating that both types of low molecular weight heparin (LMWH) is prohibited except in darurah only due to its porcine preparation ground. Thus, this paper embarks to expound to which extent unlawful sources for medical prevention and treatment can be used for Muslim consumption. Is it only when a darurah condition is announced as an exemption situation that the intoxicating material is allowed in medicine? This research employs qualitative methodology using document review method to analyse the content of the document including medical journals and Shariah books. Observing the alarming maternal mortality due to VTE during pregnancy and puerperium in Malaysia nowadays, it is true that VTE is a fatal and life threatening illness. Due to that, LMWH is recommended by the Ministry Health of Malaysia (MOH). With LMWH features of accessibility, feasibility, effective and safety profile, it becomes the first line of option among O&G doctors in Malaysia albeit it is porcine based. Therefore, this paper found that the prevention of VTE using LMWH when diagnosed as a moderate risk during pregnancy and low risk during puerperium is allowed in the shariah perspective based on Islamic legal maxim namely Al-Hajah Tunazzal Manzilah Darurah.

Fatwa on Clexane and Fraxiparine which are used for Venous Thromboembolism (VTE) during pregnancy and puerperium, imposed by the Malaysian National Fatwa Council (MNFC) in 2009 stating that both types of low molecular weight heparin (LMWH) is prohibited except in darurah only due to its porcine preparation ground. Thus, this paper embarks to expound to which extent unlawful sources for medical prevention and treatment can be used for Muslim consumption. Is it only when a darurah condition is announced as an exemption situation that the intoxicating material is allowed in medicine? This research employs qualitative methodology using document review method to analyse the content of the document including medical journals and Shariah books. Observing the alarming maternal mortality due to VTE during pregnancy and puerperium in Malaysia nowadays, it is true that VTE is a fatal and life threatening illness. Due to that, LMWH is recommended by the Ministry Health of Malaysia (MOH). With LMWH features of accessibility, feasibility, effective and safety profile, it becomes the first line of option among O&G doctors in Malaysia albeit it is porcine based. Therefore, this paper found that the prevention of VTE using LMWH when diagnosed as a moderate risk during pregnancy and low risk during puerperium is allowed in the shariah perspective based on Islamic legal maxim namely Al-Hajah Tunazzal Manzilah Darurah.

Blood clotting or Venous Thromboembolism (VTE) during pregnancy following Covid-19 infections can lead to catastrophic event. The hypercoagulable state of pregnancy is increased following Covid-19 inflammatory reaction leading to extensive use of Low Molecular Heparin (LMWH). This paper aims to analyse the methodologies used in imposing fatwa or legal rule (ḥukm) upon LMWH issue due to its porcine origin. Thromboprophylaxis with LMWH is permissible for critical (ḍarūrah) condition in VTE events as commonly agreed by majority Muslim scholars. However, with the increasing maternal mortality and morbidity due to VTE following recent Covid-19 pandemic in Malaysia, a dire need of an emergency buffer to contemplate the description of ḍarūrahand its level of severity. LMWH has been used widely as thromboprophylaxis and treatment among pregnant women especially in Covid-19 related coagulopathy. However, does LMWH allowed only when the women are at risk determined as ḍarūrahas mentioned by Islamic institutions around the world? The sighah term in ḍarūrahas imposed in the fatwa by Islamic institutions at national and international level with regards to the above mentioned based on document review method. Thisstudy concludesthat prompt action should be taken by Islamic Institutions to respond on the use of thromboprophylaxis with LMWH upon pregnant women with Covid-19 infection by addressing the issue of hifz al-nafs in determining the minimum level ḍarūrahknown as tenacious ḥājah(need) and maximum level of ḍarūrah. Thus, signifies the proficiency of Muslim scholars in current contemporary issues.

Debates over halal and haram regarding foods and non-foods have heatedly discussed amongst shariah scholar most of the times especially in Muslim country such as Malaysia. Through our naked eye, impure elements can be cleansed and purified by washing away the stain. By transforming from an impure form to pure form by mixing the thing with other substance in order to change it into a total content and form could be defined as istihalah. Its validity as a measurement tool in determining the status of halal and haram over food and non-food issues is a legal method in Islam. However, there is school of thought in Islamic fiqh observed as more stringent and stricter in verifying istihalah as legal indicator in imposing fatwa with regard halal and haram status as implemented by Malaysian National Fatwa Council (MNFC) towards porcine based medicine namely Low Molecular Weight Heparin (LMWH). Even though the present era shows its cruciality towards a need of accepting a contemporary way of fiqh approach, not to mention the efficacy, accessibility, and feasibility of LMWH, but MNFC remained observed has less enthusiasm upon istihalah method because that Islamic fatwa organization in Malaysia is more prone to Shafi’iyyah school of thought which accepting istihalah with exceptions only. This notion creates a query reason over the fatwa upon pharmaceutical issues nowadays which able to lead to misconception to the patients who might necessarily need LMWH. This qualitatively study attempts to propose a rational and harmoniously conforming to science and technology development in manufacturing the medicine which able to remove the Deoxyribonucleic acid (DNA) of the porcine. This study may contribute to solve the issue of pharmaceutical products which manufactured from impure basis by adapting a shariah compliance guideline provided at the end of study.

Istihalah and istihlak are not an extraterrestrial subject and have been debated over centuries among shariah scholars. Halal Pharmaceutical had been clearly explained that must comply with shariah prerequisite to be endorsed as halal compliance medicine. However, this industry often faces unmatched medicine which able to heal deteriorated diseases such as thrombosis or embolism that require second opinion by Shariah scholars. The medicine named Low Molecular Weight Heparin (LMWH) had been imposed the fatwa on it by Malaysian National Fatwa Council (MNFC), however, some exempted conditions require this porcine base medicine for prophylaxis or therapy. This paper aims to propose istihalah and istihlak to be legal indicators through fiqh methods in the making of fatwa regarding to this notorious medicine. This paper employs qualitative methodology which using documents review method to analysis the data.

Objectives: Preeclampsia can manifest from mild proteinuria in pregnancy with high blood pressure to eclampsia, which is characterized by concomitant fetal growth limitation or placental insufficiency and a greater degree of multi-organ involvement. There are several developing biochemical tools that can be used to detect and predict it early in pregnancy, yet many are expensive. Thus, this study aimed to determine the prevalence of preeclampsia over 5 year period (2016–2020) in Hospital Ampang, Selangor Malaysia. To review the maternal and fetal outcome in our center. Methods: Retrospective data of all pregnant women with preeclampsia delivered in Hospital Ampang over 5 years duration (2016 till 2020) were reviewed. Patients with a confirmed diagnosis of preeclampsia and valid documentation were recruited and descriptively analyzed. Results: The prevalence of preeclampsia was 0.34% (N=156) with a total of 45 677 deliveries. Malay ethnicity was the majority (70.9%), with mean reproductive age of 30.3 (SD 5.9) and mean parity of 1.8 (SD 1.5). 40.5% neonatal admission to intensive care unit at birth with mean weight upon birth was 2.21 kg (SD 0.77). Two-third of the babies were low birth weight (LBW) (50.3%; less 2.5 kg) and very low birth weight (VLBW) (21.9%, less1.5 kg) contributed by prematurity and growth-restricted fetus. Conclusions: The Preeclampsia prevalence seems not to change over the last decade worldwide. Despite early risk stratification and low-dose aspirin commenced and emphasized. Perhaps the use of placental biochemical parameters and considering weight-adjusted aspirin dosage may reflect a different maternal and fetal outcome.

Physiological changes in pregnancy makes the pregnancy a hypercoagulable state. Recent Malaysian maternal mortality enquiry in 2016-2017 statistic revealed that the principal cause of maternal death is caused by venous thromboembolism (VTE) particularly pulmonary Embolism (PE). Low Molecular Weight Heparin (LMWH) is the treatment of choice in pregnancy due to its efficacy, effectiveness and safety profile which is superior then other anticoagulants. Unfortunately, LMWH is porcine base anticoagulant which creates a huge hesitancy and dilemma amongst Muslim medical practitioners. Perplexity especially in preventive treatment as the national fatwa issued permissible usage only in life threatening necessity. The objective of this study is to evaluate the principals in shariah towards mothers at risk of VTE during pregnancy and puerperium whom will be prescribed porcine base anticoagulant as prophylaxis. Utilizing textual content analysis in this qualitative research, the outcome will clarify the feasibility by al-zikr or ahl al-khibrah in porcine based medication as VTE prophylaxis treatment. This study aimed to purpose a new perspective in delineating the dilemma among Muslim practitioner.