title: Aspirin and heparin in pregnancy.
abstract: BACKGROUND
  A pro-coagulant state during pregnancy can be involved in the occurrence of gestational vascular complications (GVCs) and venous thromboembolism (VTE).
  
  
  METHODS
  Antithrombotic drugs are used to prevent GVCs and VTE. Aspirin is not efficacious to prevent recurrences in women with previous early loss, while it can prevent pre-eclampsia in some groups of women. Heparins are not effective in the prevention of early recurrent loss and there is uncertainty about their efficacy in women carrying inherited thrombophilias. They could be efficacious in the prevention of GVCs in carriers of inherited thrombophilias, as GVCs have heterogeneous causes, and future studies have to focus on more homogeneous groups of patients. Not enough data are available regarding prophylaxis with heparins to prevent pregnancy-related VTE, but an accurate risk stratification of women during pregnancy and puerperium is crucial for administering prophylaxis in moderate-/high-risk women. Aspirin does not improve live births after assisted reproductive technologies, while heparins increase the number of clinical pregnancies and live births.
  
  
  CONCLUSIONS
  Aspirin is efficacious in the prevention of GVCs in women at risk for pre-eclampsia and in those with antiphospholipid antibodies syndrome. Heparins could give benefit to women at risk for GVCs and/or pregnancy-related VTE.
authors.affiliation: Unita' di Aterosclerosi e Trombosi, I.R.C.C.S. 'Casa Sollievo della Sofferenza' , S. Giovanni Rotondo (FOGGIA) , Italy +39 0 882 416 286 ; +39 0 882 416 273 ; e.grandone@operapadrepio.it.
authors.forename: Elvira
authors.initials: E
authors.lastname: Grandone
authors.forename: Michela
authors.initials: M
authors.lastname: Villani
authors.forename: Giovanni L
authors.initials: GL
authors.lastname: Tiscia
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D001241:Aspirin / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006493:Heparin / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D027724:Reproductive Techniques, Assisted; D012306:Risk; D019851:Thrombophilia / Q000188:drug therapy*; D014652:Vascular Diseases / Q000188:drug therapy* / Q000517:prevention & control; D054556:Venous Thromboembolism / Q000517:prevention & control
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents; D006493:Heparin; D001241:Aspirin
keywords: aspirin; gestational vascular complications; heparin; venous thromboembolism