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Research Article Open access CC BY 3.0

Prophylaxis with Low Molecular Weight Heparin for Prevention of Placenta-related Recurrent Adverse Pregnancy Outcomes

Joel H. Kamda, Alessandro Ghidini, John C. Pezzullo, Sarah H. Poggi

International Blood Research & Reviews · pp. 140–148 · Published 9 Apr 2014

10.9734/IBRR/2014/9703

Abstract

Aims: To determine whether antenatal administration of low-molecular-weight-heparin (LMWH) reduces the recurrence of adverse pregnancy outcomes (APO). Study Design: Retrospective cohort study. Place and Duration of the Study: Inova Alexandria Hospital, Alexandria, VA and Georgetown University Medical Center, Washington, DC during the period of January 1, 2006 and December 31, 2009. Methodology: All pregnant women with history of APOs, including preeclampsia or abruption at <35 weeks, birth weight <5th centile, fetal loss at ≥20 weeks, or ≥2 spontaneous losses between 12 and 20 weeks, were administered LMWH or not at the discretion of the managing physician. Excluded were cases with antiphospholipid syndrome. The independent effect of LMWH on recurrence was assessed using logistic regression analysis with odds ratios (OR) having 95% confidence interval (CI) not inclusive of the unity considered significant. Results: Of the 140 women in the cohort, 44 (31%) received LMWH during the subsequent pregnancy and the remainder did not. APO recurred in 23.6% (33/140). Logistic regression analysis demonstrated that LMWH significantly and independently lowered the risk of recurrent APO (adjusted OR=0.08, 95% CI 0.01-0.45), whereas history of fetal growth restriction (OR=3.88, 95% CI 1.51-9.99) and positive results for inherited thrombophilias (OR=6.96, 95% CI 1.58-30.67) increased the risk. Conclusion: In patients with rigorously defined history of severe APO, prophylaxis with LMWH is associated with a significant reduction in recurrence of severe APO.  

Low molecular weight heparin pregnancy complication preeclampsia fetal growth restriction abruption fetal death recurrence

References (29)

  1. 1 A united states national reference for fetal growth [DOI]
  2. 2 Inadequate maternal vascular response to placentation in pregnancies complicated by pre‐eclampsia and by small‐for‐gestational age infants [DOI]
  3. 3 Trophoblastic invasion of human decidua from 8 to 18 weeks of pregnancy [DOI]
  4. 4 Thrombophilia in pregnancy: a systematic review [DOI]
  5. 5 The physiological response of the vessels of the placental bed to normal pregnancy [DOI]
  6. 6 Low-molecular-weight heparin versus low-dose aspirin in women with one fetal loss and a constitutional thrombophilic disorder [DOI]
  7. 7 Dalteparin for the prevention of recurrence of placental-mediated complications of pregnancy in women without thrombophilia: a pilot randomized controlled trial [DOI]
  8. 8 Low‐molecular‐weight heparin added to aspirin in the prevention of recurrent early‐onset pre‐eclampsia in women with inheritable thrombophilia: the FRUIT‐RCT [DOI]
  9. 9 Efficacy and safety of two doses of enoxaparin in women with thrombophilia and recurrent pregnancy loss: the LIVE‐ENOX study [DOI]
  10. 10 Recurrence of Ischemic Placental Disease [DOI]
  11. 11 Inherited Thrombophilia and Pregnancy Complications Revisited [DOI]
  12. 12 Addition of enoxaparin to aspirin for the secondary prevention of placental vascular complications in women with severe pre-eclampsia [DOI]
  13. 13 Inherited thrombophilia and preeclampsia within a multicenter cohort: the Montreal Preeclampsia Study [DOI]
  14. 14 Prevention of fetal growth retardation with low-dose aspirin: findings of the EPREDA trial [DOI]
  15. 15 The human placental bed: Electron microscopic study of trophoblastic invasion of spiral arteries [DOI]
  16. 16 A systematic review of the association between factor V Leiden or prothrombin gene variant and intrauterine growth restriction [DOI]
  17. 17 LOW-MOLECULAR-WEIGHT HEPARIN FOR THE PREVENTION OF OBSTETRIC COMPLICATIONS IN WOMEN WITH THROMBOPHILIAS [DOI]
  18. 18 Recurring Complications in Second Pregnancy [DOI]
  19. 19 Reduction of high fetal loss rate by anticoagulant treatment during pregnancy in antithrombin, protein C or protein S deficient women [DOI]
  20. 20 Genetic Thrombophilias and Intrauterine Growth Restriction [DOI]
  21. 21 Adverse Pregnancy Outcome, the Uteroplacental Interface, and Preventive Strategies [DOI]
  22. 22 Low-molecular-weight heparin combined with aspirin in pregnant women with thrombophilia and a history of preeclampsia or fetal growth restriction: a preliminary study [DOI]
  23. 23 Prophylaxis of Recurrent Preeclampsia: Low-Molecular-Weight Heparin plus Low-Dose AspirinversusLow-Dose Aspirin Alone [DOI]
  24. 24 Genetic Risk Factors for Placental Abruption [DOI]
  25. 25 Low molecular weight heparin to achieve live birth following unexplained pregnancy loss: a systematic review [DOI]
  26. 26 Obstetric complications and pregnancy-related venous thromboembolism: The effect of low-molecular-weight heparin on their prevention in carriers of factor V Leiden or prothrombin G20210A mutation [DOI]
  27. 27 Small-for-Gestational-Age Infants and Risk of Fetal Death in Subsequent Pregnancies [DOI]
  28. 28 Antithrombotic prophylaxis in multiparous women with preeclampsia or intrauterine growth retardation in an antecedent pregnancy.
  29. 29 Antithrombotic therapy for improving maternal or infant health outcomes in women considered at risk of placental dysfunction [DOI]

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