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June 1, 2000International Journal of Gynecology & Obstetrics

Low‐molecular‐weight heparin for thrombophilia in pregnant women

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Why the study?

Does low-molecular-weight heparin combined with low-dose aspirin increase the risk of congenital malformations or adverse pregnancy outcomes compared to low-dose aspirin alone in pregnant women with thrombophilia?

Population

46 pregnant women with a history of recurrent abortions, intrauterine fetal death or intrauterine growth…

Comparison

Low-molecular-weight heparin in combination with… vs Low-dose aspirin alone (100 mg daily) (n=15).

Design

Cohort

Follow-up

throughout pregnancy

Authors

JBJacob BarWolfson Medical CenterBCBina Cohen-SacherRabin Medical CenterMHMoshe HodTel Aviv University

Discussion

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Implication

Supports LMWH safety in thrombophilic pregnancies; hypothesis-generating and requires RCTs before practice change.

Structured PICO

Does low-molecular-weight heparin combined with low-dose aspirin increase the risk of congenital malformations or adverse pregnancy outcomes compared to low-dose aspirin alone in pregnant women with thrombophilia?

P
Population
46 pregnant women with a history of recurrent abortions, intrauterine fetal death or intrauterine growth restriction (IUGR) and severe early-onset preeclampsia, with a history of thromboembolism or positive findings for thrombophilia.
I
Intervention
Low-molecular-weight heparin (enoxaparin sodium, 40 mg daily) in combination with low-dose aspirin (100 mg daily) initiated in the first trimester (n=14) or the second trimester (n=17).
C
Comparator
Low-dose aspirin alone (100 mg daily) (n=15).
O
Outcome
Incidence of congenital malformations or abortions, IUGR or preterm deliveries.safety

The use of low-molecular-weight heparin appears safe and does not increase teratogenic risk in pregnant women with thrombophilia.

Limitations

  • small size of the study groups

Cite This Study

Bar et al. (2000) studied this question.

synapsesocial.com/papers/6a83c0b16de9cd8ef3ee78b9https://doi.org/10.1016/s0020-7292(00)00202-2
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Also Consider

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

  1. 1Safety of Low-Molecular-Weight Heparin in Pregnancy: A Systematic Review1999 · 553 citations
  2. 2The Second International Anti-Cardiolipin Standardization Workshop/The Kingston Anti-Phospholipid Antibody Study (KAPS) Group1990 · 416 citations
  3. 3Low-Molecular-Weight Heparin During Pregnancy and Delivery: Preliminary Experience With 41 Pregnancies1996 · 152 citations
  4. 4Low Molecular Weight Heparin Novo (LHN-1) Does Not Cross the Placenta During the Second Trimester of Pregnancy1989 · 108 citations
  5. 5Randomised controlled trial of aspirin and aspirin plus heparin in pregnant women with recurrent miscarriage associated with phospholipid antibodies (or antiphospholipid antibodies)1997 · 1,129 citations