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January 1, 1992Thrombosis and Haemostasis

Use of Low Molecular Weight Heparin in Pregnancy

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Why the study?

Does low molecular weight heparin cross the placental barrier and safely prevent thrombosis in pregnant patients with severe thromboembolic tendency?

Population

26 pregnant patients, comprising 15 undergoing therapeutic termination of pregnancy and 11 with severe…

Comparison

Low molecular weight heparin vs 8 control patients undergoing therapeutic…

Design

Cohort

Follow-up

shortly after delivery (for the 11-patient cohort)

Authors

EMEuthemia MelissariOnassis Cardiac Surgery CenterCPChris ParkerLoughborough UniversityNWN. WilsonKing's College Hospital

Discussion

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Implication

May support LMWH thromboprophylaxis in high-risk pregnancies without fetal exposure; leaves open confirmation in larger randomized trials.

Structured PICO

Does low molecular weight heparin cross the placental barrier and safely prevent thrombosis in pregnant patients with severe thromboembolic tendency?

P
Population
26 pregnant patients, comprising 15 undergoing therapeutic termination of pregnancy and 11 with severe thromboembolic tendency, recurrent miscarriages, and poor response to conventional anticoagulation.
I
Intervention
Low molecular weight (LMW) heparin (5,000 anti-FXa units subcutaneously 15 and 3 h prior to termination in the first group; thromboprophylactic doses during pregnancy in the second group)
C
Comparator
8 control patients undergoing therapeutic termination of pregnancy (no LMW heparin); no comparator for the 11-patient high-risk cohort
O
Outcome
Heparin activity in paired maternal and fetal blood samples (for the termination group); pregnancy outcome and bone mineral mass (for the thromboprophylactic group)safety

LMW heparin does not cross the placenta and appears safe and effective for thromboprophylaxis during pregnancy without causing maternal osteoporosis.

Limitations

  • preliminary data regarding osteoporosis
  • needs further investigation

Cite This Study

Melissari et al. (1992) studied this question.

synapsesocial.com/papers/6a207dd9df4cd797f4f41e37https://doi.org/10.1055/s-0038-1646338
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Low‐Molecular‐Weight Heparins in Pregnancy1999 · 80 citations
  2. 2Use of low molecular weight heparin for prophylaxis and treatment of thromboembolism in pregnancy1992 · 74 citations
  3. 3Safety of Low-Molecular-Weight Heparin in Pregnancy: A Systematic Review1999 · 554 citations
  4. 4Thromboembolic prophylaxis with low molecular weight heparin during pregnancy1994 · 46 citations
  5. 5Low‐molecular‐weight heparin for thrombophilia in pregnant women2000 · 40 citations