Funding sources: None
Overview of low molecular weight heparin for preventative treatment of adverse obstetric outcomes related to abnormal placentation
Article first published online: 13 MAY 2014
© 2014 John Wiley & Sons, Ltd.
Special Issue: Abnormal Placentation and Adverse Obstetric Outcomes: Screening, Diagnosis and Treatment
Volume 34, Issue 7, pages 649–654, July 2014
How to Cite
Ghidini, A. (2014), Overview of low molecular weight heparin for preventative treatment of adverse obstetric outcomes related to abnormal placentation. Prenat. Diagn., 34: 649–654. doi: 10.1002/pd.4385
Conflicts of interest: None declared
- Issue published online: 8 JUL 2014
- Article first published online: 13 MAY 2014
- Accepted manuscript online: 21 APR 2014 02:07AM EST
- Manuscript Accepted: 9 APR 2014
- Manuscript Revised: 7 APR 2014
- Manuscript Received: 3 MAR 2014
Different proportions of cases of preterm and severe preeclampsia, placental abruption, fetal growth restriction, and fetal death share a common causal pathway of abnormal placental implantation. Documentation of an association between the risk of such adverse pregnancy outcomes (APOs) and inherited thrombophilias prompted initial studies to evaluate the benefit of anticoagulants for the prevention of recurrences both in patients with and without inherited thrombophilias. Prenatal administration of low molecular weight heparin (LMWH) has been evaluated in case control, cohort and randomized clinical trials. The evidence suggests a benefit of LMWH in the reduction of recurrences of APOs, with a number needed to treat of 6 (95% confidence interval: 4–10) to prevent one case of recurrent APOs. Such benefit is independent of the presence of inherited thrombophilias or the administration of low dose aspirin. Further studies are needed to establish the optimal duration for the prophylaxis, to better delineate the mechanism of action of LMWH and to explore the role, if any, of maternal serum markers and uterine artery Doppler findings in the modulation of the LMWH prophylaxis. © 2014 John Wiley & Sons, Ltd.