Inherited thrombophilia: treatment during pregnancy.
OBJECTIVE
Inherited thrombophilia is associated with thromboembolic events and/or poor obstetric outcome. We evaluated the pregnancy outcome in women with inherited thrombophilia treated with low-molecular-weight heparin (LMWH).


METHODS
38 thrombophilic women with a history of thromboembolic events and/or poor obstetric outcome were treated during their 39 consecutive pregnancies with LMWH from pregnancy verification until 4-6 weeks in puerperium. A fixed dose of enoxaparin 4,000 IU/day (except 1 case who required nadroparin 0.3 ml/day) was administered in most cases, adopting a higher dose (6,000 IU/day to 6,000 IU twice a day) in those with previous thromboembolic events.


RESULTS
In the treated women, all had a good obstetric outcome, whereas in the previous untreated pregnancies (n = 78), the rate of fetal loss (early and late) was 76.9%, only 12 live infants survived (66.6%). Moreover, birth weight resulted significantly higher in live infants born to treated pregnancies in comparison to that of previous untreated pregnancies (p = 0.009). No maternal thrombosis or major bleeding complications were recorded.


CONCLUSIONS
The treatment with LMWH improved pregnancy outcome resulting effective and safe in thrombophilic women with a history of thromboembolic events and/or poor obstetric outcome.
De Carolis
Sara
S
Department of Obstetrics and Gynecology, Catholic University, Rome, Italy.
Ferrazzani
Sergio
S
De Stefano
Valerio
V
Garofalo
Serafina
S
Fatigante
Gabriella
G
Rossi
Elena
E
Leone
Giuseppe
G
Caruso
Alessandro
A
D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001724:Birth Weight; D002585:Cesarean Section; D036861:Delivery, Obstetric / Q000379:methods; D017984:Enoxaparin / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005313:Fetal Death / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy*; D011256:Pregnancy Outcome; D013923:Thromboembolism / Q000517:prevention & control; D019851:Thrombophilia / Q000188:drug therapy* / Q000235:genetics*
D000925:Anticoagulants; D017984:Enoxaparin