Low Molecular Weight Heparin in Obstetric Care: A Review of the Literature

Low molecular weight heparins (LMWHs) are widely used during pregnancy since several randomized controlled trials have demonstrated their important role in preventing not only thromboembolic disease but also pregnancy complications associated with thrombophilia: recurrent pregnancy loss (RPL), fetal...

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Bibliographic Details
Published in:Reproductive sciences (Thousand Oaks, Calif.) Calif.), 2011-07, Vol.18 (7), p.602-613
Main Authors: D'Ippolito, Silvia, Ortiz, Amparo Santamaria, Veglia, Manuela, Tersigni, Chiara, Di Simone, Nicoletta
Format: Article
Language:English
Subjects:
Biological and medical sciences
Clinical Trials as Topic - methods
Delivery. Postpartum. Lactation
Diseases of mother, fetus and pregnancy
Embryology
Evidence-Based Medicine - methods
Female
Gynecology. Andrology. Obstetrics
Hematologic and hematopoietic diseases
Heparin, Low-Molecular-Weight - therapeutic use
Humans
Medical sciences
Medicine & Public Health
Obstetrics/Perinatology/Midwifery
Platelet diseases and coagulopathies
Pregnancy
Pregnancy Complications, Hematologic - prevention & control
Pregnancy. Fetus. Placenta
Reproductive Medicine
Review
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Summary:Low molecular weight heparins (LMWHs) are widely used during pregnancy since several randomized controlled trials have demonstrated their important role in preventing not only thromboembolic disease but also pregnancy complications associated with thrombophilia: recurrent pregnancy loss (RPL), fetal growth restriction (FGR), preeclampsia (PE), abruptio placentae and intrauterine fetal death (IUFD). LMWHs have revealed their effectiveness in reducing the recurrence of negative obstetrics events even in patients without known trombophilias, despite the mechanisms whereby LMWHs operate remain still unclear. However, in order to confirm the suggested benefits, adequately powered and properly controlled trials are needed in this area. Such trials are currently underway and their results will be important to inform evidence-based practice in this area. In our review we report the results of the most relevant trials performed to assess the efficacy of LMWHs in preventing pregnancy complications associated or not with maternal thrombophilia. This review was conducted based on a MEDLINE search for relevant articles between January 2000 and August 2010 and using the following search terms: heparin, low molecular weight heparin, thrombophilia, pregnancy complications, preeclampsia, recurrent pregnancy loss, abruptio placentae, fetal growth restriction.
ISSN:1933-7191
1933-7205
DOI:10.1177/1933719111404612