Prevention of Preeclampsia with Heparin and Antiplatelet Drugs in Women with Renal Disease
Article first published online: 28 JUN 2008
Australian and New Zealand Journal of Obstetrics and Gynaecology
Volume 35, Issue 4, pages 357–362, November 1995
How to Cite
North, R.A., Ferrier, C., Gamble, G., Fairley, K.F. and Kincaid-Smith, P. (1995), Prevention of Preeclampsia with Heparin and Antiplatelet Drugs in Women with Renal Disease. Australian and New Zealand Journal of Obstetrics and Gynaecology, 35: 357–362. doi: 10.1111/j.1479-828X.1995.tb02141.x
- Issue published online: 28 JUN 2008
- Article first published online: 28 JUN 2008
Summary: In a retrospective cohort study of women with renal disease in pregnancy we investigated if:
- 1low dose aspirin reduced die prevalence of preeclampsia and improved fetal outcome compared to no anticoagulant therapy.
- 1heparin plus low dose aspirin and/or dipyridamole reduced die prevalence of preeclampsia and improved fetal outcome compared to i. no treatment ii. low dose aspirin alone.
Women with renal disease were allocated into 3 groups according to the treatment received during their pregnancies: I. no prophylactic heparin or antiplatelet drags, n=76 II. prophylactic low-dose aspirin 75(50–150)mg, n=27 III. prophylactic subcutaneous heparin 10,000 (5000-12,500) IU b.d. combined witii low-dose aspirin 50 (50–150)mg and/or dipyridamole 400 (200–400)mg, n=44. Preeclampsia and fetal outcome was analysed according to treatment group.
Preeclampsia was less common in the heparin group (2.3%) compared with 27.6% in the no treatment group [O.R. 0.06 (0.01-0.30)] and 25.9% in the aspirin group [O.R. 0.07 (0.01-0.38)].Women on aspirin, who developed preeclampsia, delivered later in pregnancy [35.4 (33–38.2) weeks] than preeclamptic women on no treatment [29 (22–38) weeks], p=0.04. There was a trend to reduced perinatal deatfis in the heparin + antiplatelet drug group, [2.3%; O.R., 0.17 (0.02-1.4)] and in the aspirin group [0%, O.R., 0.13 (0.01–2.3)] compared with 11.7% perinatal deaths in the no treatment group.
Heparin widi anti-platelet drugs may prevent preeclampsia in high risk women witfi renal disease. Further investigation in a randomized trial is indicated.