Article

Low molecular weight heparin treatment during subsequent pregnancies of women with inherited thrombophilia and previous severe pregnancy complications.

Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv University, Israel.
The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians (impact factor: 1.36). 01/2011; 24(8):1042-5. DOI:10.3109/14767058.2010.545911 pp.1042-5
Source: PubMed

ABSTRACT The aim of this study was to investigate the effect of low molecular weight heparin (LMWH) on incidence of adverse outcome in women with thrombophilias and previous severe pregnancy complications.
The study included 116 women with history of severe preeclampsia, fetal growth restriction (FGR)  ≤5th percentile, severe placental abruption and stillbirth  >20 weeks carrying factor V Leiden or prothrombin mutations, or protein S or C deficiency. Eighty-seven women referred to us for follow-up were treated with LMWH starting from weeks 5-15 (study group, A). Twenty-nine non-treated women referred only for delivery in our institution constituted the control group (B).
The incidence of severe pregnancy complications in previous pregnancies was similar in both groups. Following treatment with LMWH, the incidence of severe preeclampsia was 4.6% in group A compared to 21% in group B, p = 0.007. The incidence of FGR was 2.3% in group A compared to 21% in group B, p = 0.03. The incidence of stillbirth or placental abruption was 0% in group A compared to 7% in group B, p = 0.06. The total incidence of adverse outcome was 7% in group A compared to 55% in group B, p = 0.0001.
LMWH treatment of women with previous severe pregnancy complications and thrombophilias significantly reduces the rate of recurrence.

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Keywords

adverse outcome
 
control group
 
fetal growth restriction
 
FGR) ≤5th percentile
 
group B
 
institution constituted
 
LMWH treatment
 
low molecular weight heparin
 
non-treated women
 
placental abruption
 
previous pregnancies
 
previous severe pregnancy complications
 
prothrombin mutations
 
severe placental abruption
 
severe preeclampsia
 
severe pregnancy complications
 
stillbirth >20 weeks
 
study group
 
thrombophilias
 
total incidence