Key result
LMWH fails to significantly reduce abortion or thrombosis vs UFH in pregnant women with mechanical valves.
Why the study?
Pregnancy increases thromboembolism risks in women with mechanical heart valves, and LMWH may cause less thrombocytopenia and bleeding than UFH.
Does low molecular weight heparin improve pregnancy outcomes and reduce complications compared to unfractionated heparin in pregnant women with mechanical heart valves during the first trimester?
RCT (n=31)
Single-blind
Block randomization
Yes
Does low molecular weight heparin improve pregnancy outcomes and reduce complications compared to unfractionated heparin in pregnant women with mechanical heart valves during the first trimester?
Absolute Event Rate: 6.3% vs 20%
p-value: p=0.333
LMWH appears to be a safe and potentially more convenient alternative to UFH in the first trimester for pregnant women with mechanical heart valves, though larger studies are needed to confirm safety and efficacy.
LMWH trends toward fewer abortions and thromboses than UFH; leaves open superiority pending larger RCTs.
Introduction: Pregnancy increases the risks of thromboembolism for the mother and fetus in patients with mechanical heart valves. The results of some studies have indicated that low molecular weight heparin (LMWH), in comparison with unfractionated heparin (UFH), leads to a lower incidence rate of thrombocytopenia and a decrease in bleeding. Methods: The present randomized clinical trial involved 31 pregnant women with mechanical heart valves at their first trimester (0-14 weeks) of pregnancy. To perform the study, the patients were divided into two groups, i.e. group A (LMWH group-16 patients) and group B (UFH group-15 patients). The birth weight, mode of delivery, and gestational age at birth as well as the maternal and fetal complications were compared between the two groups. Results: The mean age of mothers in the UFH and LMWH groups was 32.67±9.11 and 31.50±5.81years, respectively (P value > 0.05). Although the rate of maternal and fetal complications was higher in the UFH group as compared with the LMWH group, the observed difference was not significant (P value > 0.05). Conclusion: LMWH can be regarded as a safer therapy for both the mother and fetus due to its lower number of refill prescriptions and fewer changes in the blood level.
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Movahedi et al. (2020) conducted an RCT in Mechanical heart valves in pregnancy (n=31). Low molecular weight heparin vs. Unfractionated heparin was evaluated on Abortion (p=0.333). Low molecular weight heparin compared to unfractionated heparin in pregnant women with mechanical heart valves resulted in lower but non-statistically significant rates of abortion (6.3% vs 20%) and thrombotic complications (0% vs 20%).
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