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Low molecular weight heparin pregnancy

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https://www.readbyqxmd.com/read/29436886/anti-xa-based-dose-changes-during-low-molecular-weight-heparin-anticoagulation-for-mechanical-prosthetic-heart-valves-during-pregnancy
#1
Eleanor Snape, Jecko Thachil, Bernard Clarke, Sarah Vause
No abstract text is available yet for this article.
February 13, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29433369/postpartum-thromboprophylaxis-in-a-multireligious-cohort-a-retrospective-review-of-indications-and-uptake
#2
Hian Yan Voon, Ming Cheng Chai, Ling Yien Hii, Rafaie Amin, Haris Njoo Suharjono
Strategies to prevent mortality from obstetric venous thromboembolism begin with identification, risk stratification and subsequently, implementation of prophylactic measures. We sought to identify the burden of pharmacologic thromboprophylaxis in postpartum women, including the main clinical indications and its uptake in a multireligious population, with Islam as the official religion. A total of 2514 deliveries between 1st January to 31st December 2016, across three centres in Malaysia were reviewed retrospectively from hospital-based registries...
February 12, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29369082/compliance-with-the-2009-royal-college-of-obstetricians-and-gynaecologists-guidelines-for-venous-thromboembolic-disease-prophylaxis-in-pregnancy-and-postpartum-period-in-uruguay
#3
Sofía Grille, Gerardo Vitureira, Rosario Morán, Lucía Retamosa, Valeria Alonso, Luis M Gómez, Federico Quartara, Florencia Feldman, Valentina López, Paola Turcatti, Viviana Castro, Leonardo Sosa, Cecilia Guillermo, Lilián Díaz, Mariana Stevenazzi
: Venous thromboembolism remains as one of the leading causes of maternal death. Prevention of venous thromboembolism in the obstetric population is challenging as recommendations for prophylaxis have low grade of evidence. Risk factors and prophylaxis guidelines have been highlighted by Royal College of Obstetricians and Gynaecologists. In 2014, we developed a written alert following this guidelines to guide thromboprophylaxis. The aim of this study is to assess recommendations compliance. This study was conducted at University-Hospital in Uruguay from January 2014 to December 2016...
January 23, 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29321641/antiphospholipid-syndrome
#4
REVIEW
Karen Schreiber, Savino Sciascia, Philip G de Groot, Katrien Devreese, Soren Jacobsen, Guillermo Ruiz-Irastroza, Jane E Salmon, Yehuda Shoenfeld, Ora Shovman, Beverley J Hunt
Antiphospholipid syndrome (APS) is an autoimmune disease characterized by the presence of antiphospholipid antibodies, such as lupus anticoagulant, anticardiolipin antibodies and anti-β2-glycoprotein 1 antibodies. APS can present with a variety of clinical phenotypes, including thrombosis in the veins, arteries and microvasculature as well as obstetrical complications. The pathophysiological hallmark is thrombosis, but other factors such as complement activation might be important. Prevention of thrombotic manifestations associated with APS includes lifestyle changes and, in individuals at high risk, low-dose aspirin...
January 11, 2018: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/29296764/antiangiogenic-effects-of-decorin-restored-by-unfractionated-low-molecular-weight-and-nonanticoagulant-heparins
#5
Amy K L Chui, Tilini N Gunatillake, Vera Ignjatovic, Paul T Monagle, Padma Murthi, Shaun P Brennecke, John M Whitelock, Joanne M Said
Pregnancies affected by preeclampsia (PE) or fetal growth restriction (FGR) display increases in thrombin generation and reductions in angiogenesis and cell growth. There is significant interest in the potential for low molecular weight heparins (LMWHs) to reduce the recurrence of PE and FGR. However, LMWH is associated with an increased risk of bleeding. Therefore, it is of vital importance to determine the exact molecular function of heparins in pregnancy if they are used as therapy for pregnant women. We aimed to determine this using our model for PE/FGR in microvascular endothelial cells...
July 11, 2017: Blood Advances
https://www.readbyqxmd.com/read/29280473/the-safety-of-low-molecular-weight-heparin-during-and-after-pregnancy
#6
Eric Lu, Joseph J Shatzel, Jennifer Salati, Thomas G DeLoughery
Importance: In industrialized countries, venous thromboembolism remains a leading cause of mortality in pregnant women. Low-molecular-weight heparin (LMWH) is the most commonly recommended anticoagulant in pregnancy, having been proven effective and safe in multiple prospective clinical trials. Objective: The aim of this article is to outline existing recommendations for proper use of LMWH in pregnancy and data on risks of LMWH. Evidence Acquisition: Wereviewed guidelines froma number of professional societies...
December 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/29251025/low-molecular-weight-heparin-use-during-pregnancy-and-risk-of-postpartum-hemorrhage-a-systematic-review-and-meta-analysis
#7
Angelo Sirico, Gabriele Saccone, Giuseppe Maria Maruotti, Elvira Grandone, Laura Sarno, Vincenzo Berghella, Fulvio Zullo, Pasquale Martinelli
INTRODUCTION: Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide with a prevalence rate of approximately 6%. Although most cases of PPH have no identifiable risk factors, the incidence of PPH has been associated to the thromboprophylaxis in pregnancy with low molecular weight heparin (LMWH). Thus, the aim of the study is to evaluate the risk of PPH in cases of pregnant women exposed to LMWH. MATERIALS AND METHODS: Electronic research was performed in OVID, Scopus, ClinicalTrials...
January 5, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29229321/the-role-of-aspirin-heparin-and-other-interventions-in-the-prevention-and-treatment-of-fetal-growth-restriction
#8
REVIEW
Katie M Groom, Anna L David
Fetal growth restriction and related placental pathologies such as preeclampsia, stillbirth, and placental abruption are believed to arise in early pregnancy when inadequate remodeling of the maternal spiral arteries leads to persistent high-resistance and low-flow uteroplacental circulation. The consequent placental ischaemia, reperfusion injury, and oxidative stress are associated with an imbalance in angiogenic/antiangiogenic factors. Many interventions have centered on the prevention and/or treatment of preeclampsia with results pertaining to fetal growth restriction and small-for-gestational-age pregnancy often included as secondary outcomes because of the common pathophysiology...
December 8, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29222251/preventing-venous-thromboembolism-during-pregnancy-and-postpartum-crossing-the-threshold
#9
REVIEW
Leslie Skeith
When should a patient with a known thrombophilia or prior venous thromboembolism (VTE) receive low-molecular-weight heparin (LMWH) prophylaxis during pregnancy and/or the postpartum period? Accurately predicting thrombotic and bleeding risks and knowing what to do with this information is at the heart of decision-making in these challenging scenarios. This article will explore the concept of a risk threshold from clinician and patient perspectives and provide guidance for the use of antepartum and postpartum LMWH prophylaxis in women with a known thrombophilia or prior VTE...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29215518/angiogenic-factor-profiles-in-pregnant-women-with-a-history-of-early-onset-severe-preeclampsia-receiving-low-molecular-weight-heparin-prophylaxis
#10
RANDOMIZED CONTROLLED TRIAL
Edouard Lecarpentier, Jean Christophe Gris, Eva Cochery-Nouvellon, Erick Mercier, Cyril Touboul, Ravi Thadhani, S Ananth Karumanchi, Bassam Haddad
OBJECTIVE: To evaluate whether daily low-molecular-weight (LMW) heparin prophylaxis during pregnancy alters profile of circulating angiogenic factors that have been linked with the pathogenesis of preeclampsia and fetal growth restriction. METHODS: This is a planned ancillary study of the Heparin-Preeclampsia trial, a randomized trial in pregnant women with a history of severe early-onset preeclampsia (less than 34 weeks of gestation). In the parent study, all women were treated with aspirin and then randomized to receive LMW heparin or aspirin alone...
January 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29169973/-maternal-death-by-venous-thromboembolic-disease
#11
M Rossignol, E Morau, M Dreyfus
Pregnancy and postpartum are very high-risk periods for venous thromboembolism events (TEE), which seems to extend far beyond the classical 6-8 weeks after childbirth. Pulmonary embolism (PE) is one of the 3 main causes of direct maternal death in western countries. Between 2010 an 2012 in France, 24 deaths were related to PE giving a maternal mortality ratio of 1/100,000, which is not different from the former report (2007-2009). PE is responsible of 9% of maternal deaths, in equal position with postpartum hemorrhage and amniotic fluid embolism...
November 20, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29145319/primary-myelofibrosis-and-pregnancy-outcomes-after-low-molecular-weight-heparin-administration-a-case-report-and-literature-review
#12
REVIEW
Roxana Elena Bohîlţea, Monica Mihaela Cîrstoiu, Crîngu Antoniu Ionescu, Emilia Niculescu-Mizil, Ana Maria Vlădăreanu, Irina Voican, Mihai Dimitriu, Natalia Turcan
RATIONALE: Primary myelofibrosis is encountered with the myeloproliferative diseases and is the least prevalent among women of childbearing age. The prognosis is guided by pancytopenia, leukemic transformation and thrombosis which are the dominant complications. PATIENT CONCERNS: Data regarding protocol management during pregnancy in the context of myelofibrosis are insufficient. Fewer than ten cases have been described until now and half of this cases have resulted in fetal death due to placental infarction during the second and third trimesters...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29135051/low-molecular-weight-heparin-and-aspirin-exacerbate-human-endometrial-endothelial-cell-responses-to-antiphospholipid-antibodies
#13
Zola Chihombori Quao, Mancy Tong, Elena Bryce, Seth Guller, Lawrence W Chamley, Vikki M Abrahams
PROBLEM: Women with antiphospholipid antibodies (aPL) are at risk for pregnancy complications despite treatment with low molecular weight heparin (LMWH) or aspirin (ASA). aPL recognizing beta2 glycoprotein I can target the uterine endothelium, however, little is known about its response to aPL. This study characterized the effect of aPL on human endometrial endothelial cells (HEECs), and the influence of LMWH and ASA. METHOD OF STUDY: HEECs were exposed to aPL or control IgG, with or without low-dose LMWH and ASA, alone or in combination...
November 14, 2017: American Journal of Reproductive Immunology: AJRI
https://www.readbyqxmd.com/read/29099629/regulatory-t-cells-improve-pregnancy-rate-in-rif-patients-after-additional-ivig-treatment
#14
Majid Ahmadi, Samaneh Abdolmohammadi-Vahid, Mahnaz Ghaebi, Leili Aghebati-Maleki, Sanam Dolati, Laya Farzadi, Aliyeh Ghasemzadeh, Kobra Hamdi, Vahid Younesi, Mohammad Nouri, Mehdi Yousefi
RIF (repeated implantation failure) women with immunologic basis and cellular abnormalities may benefit from intravenous immunoglobulins (IVIG) as an immunomodulator based on different studies. In this study, we evaluated the effect of IVIG on the frequency and function of Th17 and Treg cells, as two important subgroups of CD4(+) T cells in implantation and pregnancy rates. Seventy-two RIF patients with preconception Th1⁄Th2 ratio and natural killer (NK) cells frequency and activity elevation were selected and divided into two groups; 40 out of 72 received IVIG, aspirin, and heparin (anoxaparin) and constituted the treatment group and 32 patients received aspirin and heparin (anoxaparin) and no IVIG and were the control group...
November 3, 2017: Systems Biology in Reproductive Medicine
https://www.readbyqxmd.com/read/29069943/pregnancy-related-osteoporotic-vertebral-compression-fractures-in-two-patients-treated-with-low-molecular-weight-heparin-during-pregnancy-case-reports
#15
Gulcan Ozturk, Pinar Akpinar, Ayse Duygu Karamanlioglu, Feyza Unlu Ozkan, Ilknur Aktas
Pregnancy-related osteoporosis (PRO) is an uncommon metabolic bone disease that can result in vertebral fragility fractures. Here we report two cases of young women who had been previously treated with LMWH-enoxaparin and were diagnosed with PRO with vertebral fragility fractures after delivery. In first case report, a 33-year-old primigravid woman who was treated with 40 mg/day of enoxaparin for eight months to prevent venous thromboembolism was presented. After delivery, Dual energy X ray absorptiometry (DEXA) revealed osteoporosis in lumbar and femoral neck region...
October 26, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/29024233/use-of-d-dimer-measurement-to-guide-anticoagulant-treatment-in-recurrent-pregnancy-loss-associated-with-antiphospholipid-syndrome
#16
Shi Hua Bao, Shi Le Sheng, Hong Liao, Qian Zhou, Sophia Twum Frempong, Wei Yan Tu
PROBLEM: To examine whether the level of plasma D-dimer can guide anticoagulant treatment in recurrent pregnancy loss (RPL) associated with antiphospholipid syndrome (APS). METHODS: A total of 1096 RPL women with APS between 2012 and 2015 in a single-center hospital were randomly divided into two groups (group A, 75 mg of low-dose aspirin [LDA] daily; group B, 75 mg of LDA plus 4100 U of low molecular weight heparin [LMWH] subcutaneously daily); 1015 of the total successfully completed the trial...
December 2017: American Journal of Reproductive Immunology: AJRI
https://www.readbyqxmd.com/read/28974635/safety-of-pregnancy-after-cerebral-venous-thrombosis-results-of-the-iscvt-international-study-on-cerebral-vein-and-dural-sinus-thrombosis-2-pregnancy-study
#17
MULTICENTER STUDY
Diana Aguiar de Sousa, Patrícia Canhão, Isabelle Crassard, Jonathan Coutinho, Antonio Arauz, Adriana Conforto, Yannick Béjot, Maurice Giroud, José M Ferro
BACKGROUND AND PURPOSE: Pregnancy is associated with increased risk of venous thrombotic events, including cerebral venous thrombosis. We aimed to study the complications and outcome of subsequent pregnancies in women with previous cerebral venous thrombosis. METHODS: Follow-up study of women with acute cerebral venous thrombosis at childbearing age included in a previously described cohort (International Study of Cerebral Vein and Dural Sinus Thrombosis). Patients were interviewed by local neurologists to assess rate of venous thrombotic events, pregnancy outcomes, and antithrombotic prophylaxis during subsequent pregnancies...
November 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28949261/administration-of-prednisolone-and-low-molecular-weight-heparin-in-patients-with-repeated-implantation-failures-a-cohort-study
#18
Charalampos Siristatidis, Konstantinos Dafopoulos, Waleed El-Khayat, George Salamalekis, George Anifandis, Tereza Vrantza, Mostafa Elsadek, Nikolaos Papantoniou
Conflicting results exist for low molecular weight heparin (LMWH) and prednisolone when tested as separate adjuncts for the improvement of the clinical outcomes in patients with repeated implantation failures (RIF) undergoing IVF/ICSI treatment. Through a cohort study, we evaluated the combined effect of both drugs on pregnancy parameters in 115 women with RIF. Clinical pregnancy rate was the primary end point while the sample size was calculated through the results of a pilot study. Clinical and IVF cycle characteristics were also compared between the groups...
February 2018: Gynecological Endocrinology
https://www.readbyqxmd.com/read/28826740/the-effect-of-parnaparin-sodium-on-in-vitro-fertilization-outcome-a-prospective-randomized-controlled-trial
#19
Corrado Lodigiani, Francesco Dentali, Elena Banfi, Paola Ferrazzi, Luca Librè, Ilaria Quaglia, Luca Cafaro, Emanuela Morenghi, Veronica Pacetti, Elena Zannoni, Anna Maria Baggiani, Paolo Emanuele Levi-Setti
INTRODUCTION: In-vitro and in-vivo models suggest the influence of low-molecular weight heparin on conception in infertile women undergoing in vitro fertilization procedures (IVF). In this randomized controlled trial we assessed whether a low-molecular weight heparin (parnaparin) could affect IVF outcomes. MATERIALS AND METHODS: 271cycles were analyzed in 247 women having a first or subsequent IVF cycle at Fertility Center of Humanitas Research Hospital. Patients, without severe thrombophilia and hormonal or active untreated autoimmune disorders, were randomly allocated (1:1) to receive for the whole cycle parnaparin, or routine hormonal therapy only...
August 15, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28756129/outcomes-of-threatened-abortions-after-anticoagulation-treatment-to-prevent-recurrent-pregnancy-loss
#20
Amihai Rottenstreich, Hagai Amsalem, Geffen Kleinstern, Yosef Kalish
We aimed to determine the outcome of threatened abortion in women treated with low-molecular weight heparin (LMWH) for recurrent pregnancy loss (RPL). Data of women with RPL who experienced threatened abortion while taking LMWH between 2007 and 2016 were retrospectively reviewed. All patients received the LMWH, enoxaparin (40 mg). Thrombophilia was present in 38 (33.3%) women, including 11 (9.6%) with antiphospholipid syndrome (APLS). The overall live birth rate was 58.8% (67/114). Live birth rates were 87...
October 2017: Reproductive Biomedicine Online
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