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Low molecular weight heparin pregnancy

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https://www.readbyqxmd.com/read/28438061/the-pattern-and-magnitude-of-invivo-thrombin-generation-differ-in-women-with-preeclampsia-and-in-those-with-sga-fetuses-without-preeclampsia
#1
Offer Erez, Roberto Romero, Edi Vaisbuch, Juan Pedro Kusanovic, Shali Mazaki-Tovi, Tinnakorn Chaiworapongsa, Francesca Gotsch, Pooja Mittal, Samuel S Edwin, Chia-Ling Nhan-Chang, Nandor Gabor Than, Chong Jai Kim, Sun Kwon Kim, Lami Yeo, Moshe Mazor, Sonia S Hassan
OBJECTIVE: We aimed to determine the differences in the pattern and magnitude of thrombin generation between patients with preeclampsia (PE) and those with SGA. METHODS: This cross-sectional study included women in the following groups: 1) normal pregnancy (NP) (n = 49); 2) PE (n = 56); and 3) SGA (n = 28). Maternal plasma thrombin generation (TGA) was measured, calculating: a) lag time (LT); b) velocity index (VI); c) peak thrombin concentration (PTC); d) time-to-peak thrombin concentration (TPTC); and e) endogenous thrombin potential (ETP)...
April 24, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28425765/the-prevention-and-treatment-of-venous-thromboembolism-in-pregnancy
#2
Michela Villani, Walter Ageno, Elvira Grandone, Francesco Dentali
Venous thromboembolism (VTE) in pregnancy represents an important cause of maternal morbidity and mortality in developed countries, with an incidence of 0.5-2.2 per 1000 pregnancies. In addition to hemostatic changes occurring during normal pregnancy, several risk factors have been identified. Thus, a variety of clinical conditions as well as fetal and maternal risks linked to a possible anticoagulant therapy should be considered for the management of VTE during pregnancy. Unfortunately, there is a paucity of high-quality evidence from randomized trials in this field, and current recommendations are based on observational studies or evidence gathered from studies in the non-pregnant population...
May 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28411702/outcomes-of-iliac-vein-stents-after-pregnancy
#3
Mohini Dasari, Efthimios Avgerinos, Seshadri Raju, Robert Tahara, Rabih A Chaer
OBJECTIVE: Stenting is the first-line treatment for obstructive iliocaval lesions when intervention is required. The aim of the study was to evaluate iliocaval stent patency during and after pregnancy in women of reproductive age who became pregnant after stent placement. METHODS: Female patients of reproductive age (18-45 years old) who underwent iliocaval stenting between May 2007 and March 2014 were identified from a three-center prospectively maintained database...
May 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28394549/the-role-of-low-molecular-weight-heparin-in-women-with-hereditary-thrombophilia-for-good-perinatal-outcome
#4
Vesna Sokol, Marina Ivanišević, Mislav Herman, Josip Đelmiš
The aim of the study was to establish the importance of low molecular weight heparin (LMWH) treatment for good pregnancy outcome in patients with hereditary thrombophilia. This retrospective study included 70 patients with inherited thrombophilia who gave birth at Zagreb University Hospital Center in the period from January 2014 to January 2015. Fifty-seven women were treated and 13 women were not treated with LMWH. Perinatal outcome was significantly better in women with hereditary thrombophilia who were treated with heparin during pregnancy as compared with women without LMWH (p=0...
June 2016: Acta Clinica Croatica
https://www.readbyqxmd.com/read/28382684/thromboembolism-and-in-vitro-fertilization-ndash-a-systematic-review
#5
Maria Sennström, Karin Rova, Margareta Hellgren, Ragnhild Hjertberg, Eva Nord, Lars Thurn, Pelle G Lindqvist
INTRODUCTION: There is no accepted consensus on thromboprophylaxis in relation to in-vitro fertilization (IVF). We aimed to study the frequency of thromboembolism and to assess thromboprophylaxis in relation to IVF. MATERIAL AND METHODS: We performed a systematic review. All study designs were accepted except single case reports. Language of included articles was restricted to English. RESULTS: Of 338 articles, 21 relevant articles (9 cohort studies, 6 case-control studies, 3 case series, and 3 reviews of case series) were identified...
April 6, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28367651/outcomes-in-an-obstetrical-population-with-hereditary-thrombophilia-and-high-tobacco-use
#6
Byron Calhoun, Elizabeth Hoover, Dara Seybold, Mike Broce, Ashley Hill, Burk Shaible, Luis A Bracero
OBJECTIVE: The purpose of this study was to examine birth outcomes in women treated or untreated for thrombophilia during pregnancies affected or not by tobacco exposure. METHODS: This was a retrospective cohort study of consecutive women from a single maternal fetal medicine clinic who delivered between January 2009 and December 2013. We compared birth outcomes by four groups of thrombophilia and smoking combinations and then by treated or untreated groups. RESULTS: Of the 8889 pregnant women in this study, 113 had thrombophilia and 97 received treatment...
April 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28329059/anticoagulation-for-pregnant-women-with-mechanical-heart-valves-a-systematic-review-and-meta-analysis
#7
Rohan D'Souza, Jackie Ostro, Prakesh S Shah, Candice K Silversides, Ann Malinowski, Kellie E Murphy, Mathew Sermer, Nadine Shehata
Aims: To review maternal and foetal outcomes in women with mechanical heart valves (MHVs) treated with vitamin-K antagonists (VKAs), first-trimester heparin followed by VKAs (sequential treatment), low molecular weight heparin (LMWH) and unfractionated heparin (UFH) during pregnancy, in order to inform practice. Methods and results: Medline, Embase and Central were searched from inception until February 2016. Two reviewers independently screened 1786 titles, reviewed 110 full-texts and extracted data and assessed risk-of-bias from 46 articles...
March 9, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28290648/deep-venous-thrombosis-and-pulmonary-embolism-current-therapy
#8
Jason Wilbur, Brian Shian
Pulmonary embolism and deep venous thrombosis are the two most important manifestations of venous thromboembolism (VTE), which is the third most common life-threatening cardiovascular disease in the United States. Anticoagulation is the mainstay of VTE treatment. Most patients with deep venous thrombosis or low-risk pulmonary embolism can be treated in the outpatient setting with low-molecular-weight heparin and a vitamin K antagonist (warfarin) or direct-acting oral anticoagulants. Inpatient treatment of VTE begins with parenteral agents, preferably low-molecular-weight heparin...
March 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28262239/lmwh-in-ivf-biomarkers-and-benefits
#9
Simon Fishel, Deborah J Baker, Ian A Greer
There is biological plausibility that coagulation activation underlies a proportion of in vitro fertilisation IVF failures and recurrent early clinical pregnancy loss (RPL). However, low-molecular-weight heparin (LMWH) use, based upon previous clinical outcome alone, is not effective in preventing RPL. RPL is heterogeneous in mechanism. Identifying those with an underlying thrombotic mechanism would allow stratification for LMWH treatment. Annexin A5 is an anticoagulant protein expressed on the trophoblast surface...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28262232/anticoagulants-to-prevent-recurrent-placenta-mediated-pregnancy-complications-is-it-time-to-put-the-needles-away
#10
Leslie Skeith, Marc Rodger
Placenta-mediated pregnancy complications, such as pre-eclampsia, placental abruption, birth of a small-for-gestational age infant and late pregnancy loss, are common and carry significant morbidity and mortality. The etiology of placenta-mediated pregnancy complications is likely multifactorial and may include abnormal coagulation activation of the maternal-fetal interface. The use of antepartum low-molecular-weight heparin (LMWH) prophylaxis to prevent recurrent placenta-mediated pregnancy complications has become common practice despite limited and conflicting evidence to support its use...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28238314/-obstetrical-aps-is-there-a-place-for-additional-treatment-to-aspirin-heparin-combination
#11
A Mekinian, G Kayem, J Cohen, L Carbillon, N Abisror, L Josselin-Mahr, M Bornes, O Fain
Obstetrical APS is defined by thrombosis and/or obstetrical morbidity associated with persistent antiphospholipid antibodies. The aspirin and low molecular weighted heparin combination dramatically improved obstetrical outcome in APS patients. Several factors could be associated with obstetrical prognosis, as previous history of thrombosis, associated SLE, the presence of lupus anticoagulant and triple positivity of antiphospholipid antibodies. Obstetrical APS with isolated recurrent miscarriages is mostly associated with isolated anticardiolipids antibodies and have better obstetrical outcome...
January 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/28231636/personalized-thromboprophylaxis-using-a-risk-score-for-the-management-of-pregnancies-with-high-risk-of-thrombosis-a-prospective-clinical-study
#12
Y Dargaud, L Rugeri, C Fleury, C Battie, P Gaucherand, C Huissoud, R C Rudigoz, H Desmurs-Clavel, J Ninet, M C Trzeciak
BACKGROUND: Patients with thrombophilia and/or a history of venous thromboembolism (VTE) are at risk of thrombosis during pregnancy. A risk score for pregnancies with increased risk of VTE was previously described by our group (Lyon-VTE-score). OBJECTIVES: The aim of this prospective study was to assess the efficacy and safety of our score-based prophylaxis strategy in 542 pregnancies managed between 2005 and 2015 in Lyon University Hospitals. PATIENTS/METHODS: Of 445 patients included in the study, 36 had several pregnancies during the study period...
February 23, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28176193/obstetric-outcomes-of-recurrent-pregnancy-loss-patients-diagnosed-w%C3%A4-th-inherited-thrombophilia
#13
C Karadağ, T Yoldemir, S D Karadağ, C İnan, Z N Dolgun, L Aslanova
BACKGROUND: Recurrent pregnancy loss (RPL) is defined by two or more failed pregnancies. The relation between RPL and inherited thrombophilia requires anticoagulant therapy during pregnancy. However the obstetric outcomes have not been well defined in these RPL patients diagnosed with inherited thrombophilia, who have been given anticoagulant therapy. AIM: To investigate the obstetric outcomes in pregnant women with RPL who are given low molecular weight heparin (LMWH) and low-dose aspirin due to diagnosis of inherited thrombophilia...
February 7, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28168066/management-of-venous-thromboembolism-in-patients-with-hereditary-antithrombin-deficiency-and-pregnancy-case-report-and-review-of-the-literature
#14
Mohammad Refaei, Lydia Xing, Wendy Lim, Mark Crowther, Kochawan Boonyawat
Background. Hereditary antithrombin deficiency is a thrombogenic disorder associated with a 50-90% lifetime risk of venous thromboembolism (VTE), which is increased during pregnancy and the puerperium in these patients. We present a case of a woman with antithrombin (AT) deficiency who presented with a VTE despite therapeutic low molecular weight heparin (LMWH). Though the pregnancy was deemed unviable, further maternal complications were mitigated through the combined use of therapeutic anticoagulation and plasma-derived antithrombin concentrate infusions to normalize her functional antithrombin levels...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/28161237/low-molecular-weight-heparins-prevent-the-induction-of-autophagy-of-activated-neutrophils-and-the-formation-of-neutrophil-extracellular-traps
#15
Angelo A Manfredi, Patrizia Rovere-Querini, Armando D'Angelo, Norma Maugeri
The protection exerted by neutrophils against invading microbes is partially mediated via the generation of neutrophil extracellular traps (NETs). In sterile conditions NETs are damaging species, enriched in autoantigens and endowed with the ability to damage the vessel wall and bystander tissues, to promote thrombogenesis, and to impair wound healing. To identify and reposition agents that can be used to modulate the formation of NETs is a priority in the research agenda. Low molecular weight heparins (LMWH) are currently used, mostly on an empirical basis, in conditions in which NETs play a critical role, such as pregnancy complications associated to autoimmune disease...
February 1, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/28153662/antiphospholipid-antibody-profile-based-obstetric-outcomes%C3%A2-of-primary-antiphospholipid-syndrome-the%C3%A2-pregnants-study
#16
Gabriele Saccone, Vincenzo Berghella, Giuseppe Maria Maruotti, Tullio Ghi, Giuseppe Rizzo, Giuliana Simonazzi, Nicola Rizzo, Fabio Facchinetti, Andrea Dall'Asta, Silvia Visentin, Laura Sarno, Serena Xodo, Dalila Bernabini, Francesca Monari, Amanda Roman, Ahizechukwu Chigoziem Eke, Ariela Hoxha, Amelia Ruffatti, Ewoud Schuit, Pasquale Martinelli
BACKGROUND: Antiphospholipid syndrome is an autoimmune, hypercoagulable state that is caused by antiphospholipid antibodies. Anticardiolipin antibodies, anti-β2 glycoprotein-I, and lupus anticoagulant are the main autoantibodies found in antiphospholipid syndrome. Despite the amassed body of clinical knowledge, the risk of obstetric complications that are associated with specific antibody profile has not been well-established. OBJECTIVE: The purpose of this study was to assess the risk of obstetric complications in women with primary antiphospholipid syndrome that is associated with specific antibody profile...
January 30, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28153659/enoxaparin-for-the-prevention-of-preeclampsia-and%C3%A2-intrauterine-growth-restriction-in-women-with%C3%A2-a%C3%A2-history-%C3%A2-a%C3%A2-randomized-trial
#17
Katie M Groom, Lesley M McCowan, Laura K Mackay, Arier C Lee, Joanne M Said, Stefan C Kane, Susan P Walker, Thijs E van Mens, Natalie J Hannan, Stephen Tong, Larry W Chamley, Peter R Stone, Claire McLintock
BACKGROUND: Preeclampsia and small-for-gestational-age pregnancy are major causes of maternal and perinatal morbidity and mortality. Women with a previous pregnancy affected by these conditions are at an increased risk of recurrence in a future pregnancy. Past trials evaluating the effect of low-molecular-weight heparin for the prevention of recurrence of preeclampsia and small-for-gestational-age pregnancy have shown conflicting results with high levels of heterogeneity displayed when trials were compared...
March 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28147377/case-report-acute-flair-of-ulcerative-colitis-during-pregnancy-is-still-a-major-problem
#18
Marijana Protic, Srdjan Markovic, Dino Tarabar
Although severe flare of ulcerative colitis (UC) is uncommon, it significantly increases the risk of preterm delivery, low birth weight and other adverse fetal outcomes. It is critical to optimize aggressive medical treatment with both mother and fetal health. Here, we present a case of a 30-year-old woman with a severe flare of UC at the 16th gestational week. The diagnosis of extensive UC was established 8 years ago. From the time she was diagnosed, she had 5 moderate flares successfully treated with oral and topical mesalamine...
2017: Digestive Diseases
https://www.readbyqxmd.com/read/28126966/obstetric-antiphospholipid-syndrome-early-variations-of-angiogenic-factors-are-associated-with-adverse-outcomes-the-noh-angio-observational-cohort-study
#19
Éva Cochery-Nouvellon, Érick Mercier, Sylvie Bouvier, Jean-Pierre Balducchi, Isabelle Quéré, Antonia Perez-Martin, Eve Mousty, Vincent Letouzey, Jean-Christophe Gris
The prognostic value of angiogenic factors in newly pregnant women with obstetric antiphospholipid syndrome has not been documented. We observed 513 obstetric antiphospholipid syndromes who experienced three consecutive spontaneous abortions before the 10th week of gestation or one fetal loss at or beyond the 10th week. We assessed the plasma concentrations of the proangiogenic factor placenta growth factor and of the antiangiogenic factor soluble fms-like tyrosine kinase-1 on the eve and on the 4th day of the low-molecular weight heparin-low dose aspirin treatment...
January 25, 2017: Haematologica
https://www.readbyqxmd.com/read/28090465/does-intrauterine-injection-of-low-molecular-weight-heparin-improve-the-clinical-pregnancy-rate-in-intracytoplasmic-sperm-injection
#20
Ahmed Mohamed Kamel, Yahia El-Faissal, Mona Aboulghar, Ragaa Mansour, Gamal I Serour, Mohamed Aboulghar
OBJECTIVE: Heparin can modulate proteins, and influence processes involved in implantation and trophoblastic development. This study aimed to assess the improvement of clinical pregnancy and implantation rates after local intrauterine injection of low-molecular-weight heparin (LMWH) in patients undergoing intracytoplasmic sperm injection (ICSI). METHODS: A randomised case/control design was followed in women scheduled for ICSI. The study arm was injected with intrauterine LMWH during mock embryo transfer immediately following the ovum pickup procedure, while the control arm was given an intrauterine injection with a similar volume of tissue culture media...
December 2016: Clinical and Experimental Reproductive Medicine
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