Heparin treatment in pregnancy loss: Potential therapeutic benefits beyond anticoagulation.
Interventions with heparin therapies have increased fetal survival in patients with antiphospholipid syndrome (APS). In this review, several physiological and pharmacological effects of heparin are described. These different mechanisms of action could explain the beneficial effects of heparin in the treatment of recurrent pregnancy loss in patients with APS. In addition to direct effects of heparin on the coagulation cascade, heparin might protect pregnancies by reducing the binding of antiphospholipid antibodies, reducing inflammation, facilitating implantation and or inhibiting complement activation.
Girardi
Guillermina
G
Department of Medicine, Hospital for Special Surgery-Weill Medical College of Cornell University, New York, NY 10021, USA. girardig@hss.edu
D000026:Abortion, Habitual / Q000188:drug therapy* / Q000209:etiology; D017152:Antibodies, Antiphospholipid / Q000276:immunology; D000925:Anticoagulants / Q000494:pharmacology / Q000627:therapeutic use*; D000937:Antigen-Antibody Reactions / Q000187:drug effects; D016736:Antiphospholipid Syndrome / Q000150:complications*; D003169:Complement Inactivator Proteins / Q000494:pharmacology / Q000502:physiology / Q000627:therapeutic use*; D003165:Complement System Proteins / Q000187:drug effects; D010064:Embryo Implantation / Q000187:drug effects; D005260:Female; D006493:Heparin / Q000494:pharmacology / Q000502:physiology / Q000627:therapeutic use*; D006801:Humans; D011247:Pregnancy
D017152:Antibodies, Antiphospholipid; D000925:Anticoagulants; D003169:Complement Inactivator Proteins; D006493:Heparin; D003165:Complement System Proteins