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April 1, 1991Blood Coagulation & Fibrinolysis

No transplacental passage of standard heparin or an enzymatically depolymerized low molecular weight heparin

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Key result

Neither standard heparin nor low molecular weight heparin demonstrated any evidence of passage across the placental barrier to the fetus.

Why the study?

Does unfragmented heparin or low molecular weight heparin pass the placental barrier to the fetus in pregnant women?

Population

36 pregnant women who had an abortion by hysterotomy between the 15th and 23rd week of pregnancy

Comparison

Unfragmented heparin or low molecular weight… vs No heparin (control group of 15 women)

Design

Cohort

Authors

TTT. M tzschDBDavid BergqvistVascular / Pulmonary VascularABAgneta BergqvistUniversity of Copenhagen

Discussion

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Overview

Supports mid-gestation heparin use without fetal exposure; leaves open confirmation at term or with chronic dosing.

Study Design

Type

Observational (n=36)

Structured PICO

Does unfragmented heparin or low molecular weight heparin pass the placental barrier to the fetus in pregnant women?

P
Population
36 pregnant women undergoing abortion by hysterotomy between the 15th and 23rd week of pregnancy, including 21 who received heparin/LMWH and 15 controls.
E
Exposure
Unfragmented heparin or low molecular weight heparin (LMWH)
C
Comparator
No heparin (control group of 15 women)
O
Outcome
Transplacental passage of heparin or LMWH to the fetus (measured by factor Xa inhibitory activity, ATIII, and heparin-like substances in fetal plasma)surrogate

Neither standard unfragmented heparin nor low molecular weight heparin crosses the placental barrier during the second trimester of pregnancy.

Limitations

  • Determination of heparin activity in foetal plasma is difficult due to the influence of endogenous ATIII on heparin assays.
  • Determination of heparin activity in fetal plasma is difficult due to the influence of endogenous ATIII on heparin assays

Cite This Study

tzsch et al. (1991) conducted an observational in Pregnancy (n=36). Standard heparin or low molecular weight heparin (LMWH) vs. No heparin was evaluated on Transplacental passage of heparin to the foetus. Neither standard heparin nor low molecular weight heparin demonstrated any evidence of passage across the placental barrier to the fetus.

synapsesocial.com/papers/6aa2249f84bb7f62fd46eda0https://doi.org/10.1097/00001721-199104000-00009
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Also Consider

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

  1. 1Use of Low Molecular Weight Heparin in Pregnancy1992 · 182 citations
  2. 2Placental transport of low molecular weight heparin in the pregnant sheep1985 · 33 citations
  3. 3Transfer of Heparin Across the Human Perfused Placental Lobule1992 · 29 citations
  4. 4Lack of Anti-Factor Xa Activity in Umbilical Cord Vein Samples after Subcutaneous Administration of Heparin or Low Molecular Mass Heparin in Pregnant Women2009 · 69 citations
  5. 5Low Molecular Weight Heparin Novo (LHN-1) Does Not Cross the Placenta During the Second Trimester of Pregnancy1989 · 108 citations