Document Detail


Use of heparin in women with early and late miscarriages with and without thrombophilia.
MedLine Citation:
PMID:  19666941     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: In women with a history of recurrent miscarriage, the risk of miscarriage in a subsequent pregnancy is about 30% to 40%. In patients with thrombophilia, the risk is even higher. Placental thrombosis has been found in women with unexplained recurrent miscarriage independent of thrombophilia. In addition, proinflammatory changes, for example, altered Th1 to Th2 cytokine ratio and complement activation, have been repeatedly demonstrated in these women. Because of the fact that heparin has both anticoagulative and anti-inflammatory effects, the current study evaluated the efficacy of low-molecular-weight heparin (LMWH) in unexplained abortions. STUDY DESIGN: A total of 164 women with unexplained early and late miscarriages presented in our hemostaseological clinic for thrombophilia screening. For these 164 women, 82 subsequent pregnancies in 79 patients were treated with subcutaneous LMWH independently of thrombophilia. In 54/82 unselected pregnancies, 100 mg aspirin was administered in addition to LMWH. Two patients were excluded due to termination of pregnancy. RESULTS: Overall, 83.8% (67/80) of pregnancies resulted in live births. In 22/79 women (27.8%), thrombophilia markers were positive. Most noteworthy, patients with thrombophilia markers had live births at a similar frequency as patients without those parameters. No severe side effects of LMWH were seen. CONCLUSIONS: Our data support the notion that LMWH is efficacious in patients with recurrent abortions and thrombophilia. We demonstrated the same effect of LMWH in women with unexplained abortions without thrombophilia. The potential mechanism of action of LMWH in early and late abortions warrants further study.
Authors:
Silke Monien; Oliver Kadecki; Susanne Baumgarten; Abdulgabar Salama; Thomas D??rner; Holger Kiesewetter
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2009-08-09
Journal Detail:
Title:  Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis     Volume:  15     ISSN:  1938-2723     ISO Abbreviation:  Clin. Appl. Thromb. Hemost.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-20     Completed Date:  2010-02-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9508125     Medline TA:  Clin Appl Thromb Hemost     Country:  United States    
Other Details:
Languages:  eng     Pagination:  636-44     Citation Subset:  IM    
Affiliation:
Department of Hemostaseology, Institute of Transfusion Medicine, Charit?? University Hospital Berlin, Berlin, Germany. silke.monien@charite.de
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MeSH Terms
Descriptor/Qualifier:
Abortion, Habitual / drug therapy,  etiology,  prevention & control*
Adult
Age Factors
Aspirin / administration & dosage,  therapeutic use
Biological Markers
Case-Control Studies
Dalteparin / administration & dosage,  therapeutic use
Drug Therapy, Combination
Female
Heparin, Low-Molecular-Weight / administration & dosage,  therapeutic use*
Humans
Inflammation / drug therapy*
Live Birth
Pregnancy
Pregnancy Outcome
Thrombophilia / complications*
Young Adult
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Dalteparin; 0/Heparin, Low-Molecular-Weight; 50-78-2/Aspirin

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