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Recurrence and severity of abnormal pregnancy outcome in patients treated by low-molecular-weight-heparin: a prospective pilot study.
MedLine Citation:
PMID:  22122225     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract Objective This prospective pilot study assesses the recurrence rate and severity of abnormal pregnancy outcome (APO), excluding early pregnancy complications, in pregnant patients, without acquired thrombophilia, treated by prophylactic doses of LMWH, independently from their congenital thrombophilic condition. Methods We recruited a cohort of 128 pregnant patients with previous APO; 100 of whom with APO and intrauterine growth restriction (IUGR), and 28 with maternal APO only. LMWH treatment was started at recruitment. Composite cross over recurrence rate IUGR, gestational hypertension, preeclampsia, HELLP, abruptio was analyzed. The main outcome measure was severe APOs with iatrogenic delivery ≤ 32 weeks of gestation. Results Median gestational age at LMWH treatment was 20 weeks. Severe APO decreased in treated pregnancies from 45% to 4% (R.R.=0.3, CI .95=0.2-0.8). This value was not significantly different in thrombophilic and non thrombophilic patients. When severe and minor complications were analyzed altogether the recurrence rate was 28%. In patients with APO and FGR in the index pregnancy, newborn weights were significantly better in the treated pregnancy: 1090g (1035-1145) vs. 850g (535-1200), P<0,01) Conclusions. Prophylactic regimen of LMWH significantly reduced the recurrence rate of severe composite APO in pregnancies affected in the index pregnancy by APO and fetal growth restriction or SGA newborns. This result was independent from the patients' inherited thrombophilic conditions.
Authors:
Valentina Conserva; Marialuisa Muggiasca; Luisa Arrigoni; Valeria Mantegazza; E Edoardo Rossi; Enrico Ferrazzi
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-29
Journal Detail:
Title:  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     Volume:  -     ISSN:  1476-4954     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
University Department of Clinical Sciences, Sacco and Buzzi Children's Hospital, Departments of Obstetrics and Gynecology, (*) Immuno-Haematology Centre, Sacco Hospital, University of Milan, Italy EU.
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