title: Does low molecular weight heparin shorten term labor?
abstract: Dalteparin, a low molecular weight heparin (LMWH), is given to pregnant women with thrombotic disorders. Clinical observations together with the documented changes of heparan sulfate proteoglycans in normal and protracted labor fostered the idea that LMWH shortens delivery time. Labor time was retrospectively determined among nulliparous pregnant women treated with dalteparin because of previous venous thromboembolism (VTE), thrombophilia or acute VTE during current pregnancy. Their labor time was compared to matched untreated controls. The proportion of instrumental deliveries and neonatal outcome was also compared. The dalteparin-treated group showed a significantly (30%) shorter labor time compared to matched controls. Total instrumental deliveries were the same in the two groups but operative intervention due to protracted labor was significantly less common in dalteparin-treated women. There was no difference in neonatal outcome. Dalteparin most likely shortens parturition time and may decrease the number of operative interventions due to protracted labor.
authors.affiliation: Department of Women and Child Health, Division of Obstetrics and Gynecology, Karolinska Institutet, Stockholm, Sweden. gunvor.ekman-ordeberg@ki.se
authors.forename: Gunvor
authors.initials: G
authors.lastname: Ekman-Ordeberg
authors.forename: Anna
authors.initials: A
authors.lastname: Akerud
authors.forename: Aurelija
authors.initials: A
authors.lastname: Dubicke
authors.forename: Anders
authors.initials: A
authors.lastname: Malmström
authors.forename: Margareta
authors.initials: M
authors.lastname: Hellgren
mesh_terms: D000293:Adolescent; D000328:Adult; D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D000925:Anticoagulants / Q000494:pharmacology*; D001034:Apgar Score; D017985:Dalteparin / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007743:Labor, Obstetric / Q000187:drug effects*; D036801:Parturition / Q000187:drug effects; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D017985:Dalteparin