title: Low molecular weight heparin treatment and impact of inherited thrombophilia type in pregnancies with previous adverse outcome.
abstract: OBJECTIVE
  To assess the impact of low molecular weight heparin (LMWH) treatment in 50 pregnancies of women with inherited thrombophilia and adverse pregnancy outcome (APO) in previous untreated pregnancies. The impact of "Conventional" (FVL, PT, AT, PC, PS) and "Novel" (MTHFR, PAI-1, ACE) thrombophilias on APO was investigated.
  
  
  METHODS
  The primary outcomes (PO) were: early and late pregnancy loss (EPL, LPL), preterm birth (PTB) or term birth (TB) compared to the last untreated pregnancies of the same women. Secondary outcomes (SO) were APO in LMWH treated and last untreated pregnancies ended with birth. PO and SO were compared in relation to the thrombophilia type.
  
  
  RESULTS
  LMWH decreased EPL and LPL rate and improved TB rate compared with last untreated pregnancies (p < 0.001). There were less PTB (p = 0.019) and no cases of intrauterine fetal death (IUFD) (p = 0.0019) in LWMH-treated pregnancies. The division to Conventional and Novel thrombophilias showed: (a) difference between pregnancy losses and birth rate (p = 0.0069) and (b) no difference in the prevalence of APO in untreated pregnancies ended with birth.
  
  
  CONCLUSIONS
  LMWH treatment improves pregnancy outcome in women with inherited thrombophilia and APO in previous pregnancies. Novel thrombophilias have the equal impact on the pregnancy outcome compared to the Conventional thrombophilias.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital Split , Split , Croatia .
authors.forename: Nada
authors.initials: N
authors.lastname: Aracic
authors.forename: Damir
authors.initials: D
authors.lastname: Roje
authors.forename: Irena
authors.initials: I
authors.lastname: Drmic Hofman
authors.forename: Vesna
authors.initials: V
authors.lastname: Capkun
authors.forename: Vedran
authors.initials: V
authors.lastname: Stefanovic
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D005260:Female; D005313:Fetal Death / Q000517:prevention & control; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D066087:Perinatal Death / Q000517:prevention & control; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy*; D011256:Pregnancy Outcome; D011446:Prospective Studies; D019851:Thrombophilia / Q000188:drug therapy*
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight
keywords: Inherited thrombophilias; low molecular weight heparin; pregnancy complications