Document Detail


Anticoagulants to prevent placenta-mediated pregnancy complications: a review of current evidence.
MedLine Citation:
PMID:  19550316     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: Placenta-mediated pregnancy complications are relatively common and are associated with significant morbidity and mortality. Although anticoagulants are increasingly being used to prevent these complications, the evidence supporting their use is limited. This article will focus on reviewing the current evidence base for the use of anticoagulants to prevent placenta-mediated pregnancy complications in women with or without identifiable thrombophilia. RECENT FINDINGS: Controversy exists whether inherited or acquired thrombophilias cause placenta-mediated complications. Small randomized studies with methodological limitations suggest that antepartum anticoagulant prophylaxis will reduce pregnancy loss in women with both acquired and inherited thrombophilia and prior pregnancy loss. There are no published randomized controlled trials examining anticoagulant prophylaxis in thrombophilic women with prior preeclampsia, intrauterine growth restriction or placental abruption. More recently, the benefit of antepartum anticoagulant prophylaxis in women without thrombophilia with prior placenta-mediated pregnancy complications has been suggested in a small pilot randomized trial. SUMMARY: Overall, although antepartum anticoagulant prophylaxis has the potential to reduce placenta-mediated pregnancy complications in women with and without identifiable thrombophilia, the data generated by these trials are methodologically limited and inadequate. Hence, we conclude that further trials are required prior to adopting the use of antepartum anticoagulant prophylaxis to prevent placenta-mediated pregnancy complications in routine clinical practice.
Authors:
Vi Dao; Marc Rodger
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Current opinion in hematology     Volume:  16     ISSN:  1531-7048     ISO Abbreviation:  Curr. Opin. Hematol.     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-13     Completed Date:  2009-11-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9430802     Medline TA:  Curr Opin Hematol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  386-90     Citation Subset:  IM    
Affiliation:
University of Ottawa, Ottawa, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Anticoagulants / therapeutic use*
Female
Humans
Placenta Diseases / prevention & control*
Pregnancy
Pregnancy Complications, Hematologic / prevention & control*
Thrombophilia / complications
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anticoagulants

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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