The effect of anticoagulation on antenatal ultrasound findings in pregnant women with thrombophilia.
OBJECTIVE
To assess whether treatment with heparin alters ultrasound findings in pregnant women with inherited thrombophilia.


METHODS
This was a retrospective study of a cohort of patients referred for pregnancy complications who were found to have genetic thrombophilia. Ultrasounds were reviewed in treated and untreated pregnancies for the presence of growth restriction, oligohydramnios or abnormal Doppler results.


RESULTS
There were a total of 178 pregnancies in 51 patients. The overall percentage of abnormal ultrasounds was significantly greater in the untreated compared with treated pregnancies (52.8% vs. 27.9%; p = 0.024.) Growth restriction and abnormal Doppler results were more common in untreated pregnancies. There was a significantly decreased risk of oligohydramnios with treatment (27.3% vs. 7%; p = 0.03). Overall outcomes were significantly improved with the use of anticoagulation ( p < 0.0001).


CONCLUSIONS
Treatment markedly improves ultrasound parameters of growth, fluid and feto-placental blood flow in patients with thrombophilia. The presence of abnormalities despite treatment reinforces the need for close antenatal surveillance.
Department of Obstetrics & Gynecology, Yale University School of Medicine, New Haven, Connecticut 06504, USA. urania.magriples@yale.edu
Urania
U
Magriples
Tulin
T
Ozcan
Anita
A
Karne
Joshua Abbott
JA
Copel
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D005313:Fetal Death / Q000000981:diagnostic imaging; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging / Q000517:prevention & control; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D009154:Mutation; D016104:Oligohydramnios / Q000000981:diagnostic imaging / Q000517:prevention & control; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D019851:Thrombophilia / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal
D000925:Anticoagulants; D006493:Heparin