Recurrence rate of pre-eclampsia in women with thrombophilia influenced by low-molecular-weight heparin treatment?
OBJECTIVE
(1) To assess the recurrence rate of pre-eclampsia in women with this history before 34 weeks of pregnancy and thrombophilia. (2) To evaluate the effects of low-molecular-weight heparin (LMWH) on pregnancy outcome.


METHODS
In a multicentre retrospective study subsequent pregnancies of women with a history of pre-eclampsia necessitating birth before 34 weeks and thrombophilia were analysed. Of 58 women, 26 received LMWH and aspirin (ASA) and 32 ASA (22) or no (10) medication in their subsequent pregnancies.


RESULTS
In eight women treated with LMWH and ASA and in 16 women receiving ASA or no medication pre-eclampsia recurred in the subsequent pregnancy. (OR 0.55, 95% CI 0.15-1.31) There were no significant differences in birth weight or gestational age between both groups.


CONCLUSIONS
The recurrence rate of pre-eclampsia in women with thrombophilic disorders is high in this small retrospective study. No positive effect was found for LMWH treatment. A multicentred randomised study has been started to reach an adequate number of patients to evaluate the influence of LMWH treatment.
Kalk
J J
JJ
Department of Obstetrics and Gynaecology, VU University Medical Centre, PO Box 7057, 1007 MB Amsterdam. JJ.Kalk@VUmc.nl
Huisjes
A J M
AJ
de Groot
C J M
CJ
van Beek
E
E
van Pampus
M G
MG
Spaanderman
M E A
ME
van Eyck
J
J
Oei
S G
SG
Bezemer
P D
PD
de Vries
J I P
JI
D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D018890:Chemoprevention; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D018579:Patient Selection; D011225:Pre-Eclampsia / Q000150:complications / Q000473:pathology / Q000517:prevention & control*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012008:Recurrence; D012189:Retrospective Studies; D019851:Thrombophilia / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight