Document Detail


Reduction of high fetal loss rate by anticoagulant treatment during pregnancy in antithrombin, protein C or protein S deficient women.
MedLine Citation:
PMID:  17223916     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Hereditary thrombophilia is associated with an increased risk of fetal loss. Assuming that fetal loss is due to placental thrombosis, anticoagulant treatment might improve pregnancy outcome. In an observational family cohort study, we prospectively assessed the effects of anticoagulant drugs on fetal loss rates in women with hereditary deficiencies of antithrombin, protein C or protein S. The cohort contained 376 women (50 probands and 326 deficient or non-deficient relatives). Probands were consecutive deficient patients with venous tromboembolism. Thromboprophylaxis during pregnancy was recommended in deficient women, irrespective of prior venous thromboembolism, and in non-deficient women with prior venous thromboembolism. Outcome of first pregnancy was analysed in 55 eligible women. Of 37 deficient women, 26 (70%) received thromboprophylaxis during pregnancy, compared with three of 18 (17%) non-deficient women. Fetal loss rates were 0% in deficient women with thromboprophylaxis versus 45% in deficient women without (P = 0.001) and 7% in non-deficient women without thromboprophylaxis (P = 0.37). The adjusted relative risk of fetal loss in women who received thromboprophylaxis versus women who did not was 0.07 (95% confidence interval 0.001-0.7; P = 0.02). Our data suggest that anticoagulant treatment during pregnancy reduces the high fetal loss rate in women with hereditary deficiencies of antithrombin, protein C or protein S.
Authors:
Nienke Folkeringa; Jan Leendert P Brouwer; Fleurisca J Korteweg; Nic J G M Veeger; Jan Jaap H M Erwich; Jozien P Holm; Jan van der Meer
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  British journal of haematology     Volume:  136     ISSN:  0007-1048     ISO Abbreviation:  Br. J. Haematol.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-02-21     Completed Date:  2007-04-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372544     Medline TA:  Br J Haematol     Country:  England    
Other Details:
Languages:  eng     Pagination:  656-61     Citation Subset:  IM    
Affiliation:
Division of Haemostasis, Thrombosis and Rheology, Department of Haematology, University Medical Centre Groningen, Groningen, the Netherlands. n.folkeringa@og.umcg.nl
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anticoagulants / therapeutic use*
Antithrombins / deficiency
Blood Coagulation Disorders, Inherited / drug therapy*
Female
Fetal Death / prevention & control*
Heparin, Low-Molecular-Weight / therapeutic use
Humans
Middle Aged
Pregnancy
Pregnancy Complications, Hematologic / drug therapy*
Prenatal Care / methods
Prospective Studies
Protein C Deficiency / drug therapy
Protein S Deficiency / drug therapy
Thromboembolism / prevention & control
Thrombophilia / drug therapy*
Treatment Outcome
Venous Thrombosis / prevention & control
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Antithrombins; 0/Heparin, Low-Molecular-Weight

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


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