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Low molecular weight heparin pregnancy

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https://www.readbyqxmd.com/read/29656983/prophylaxis-and-treatment-of-foetal-growth-restriction
#1
REVIEW
Aamod Nawathe, Anna L David
Foetal growth restriction (FGR) and associated placental pathologies such as pre-eclampsia and stillbirth arise in early pregnancy when inadequate remodelling of maternal spiral arteries leads to persistent high-resistance low-flow uteroplacental circulation. Current interventions concentrate on targeting the placental ischaemia-reperfusion injury and oxidative stress associated with an imbalance in angiogenic/anti-angiogenic factors. Recent meta-analyses confirm that aspirin modestly reduces the risk for small-for-gestational-age pregnancy in high-risk women...
February 23, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29603135/treatment-efficacy-for-idiopathic-recurrent-pregnancy-loss-a-systematic-review-and-meta-analyses
#2
Emma Rasmark Roepke, Margareta Hellgren, Ragnhild Hjertberg, Lennart Blomqvist, Leif Matthiesen, Emir Henic, Sujata Lalitkumar, Annika Strandell
INTRODUCTION: Medical treatment of women with idiopathic recurrent pregnancy loss is controversial. The objective was to assess the effects of different treatments on live birth rates and complications in women with unexplained recurrent pregnancy loss. MATERIAL AND METHODS: We searched Medline, Embase, the Cochrane Library and identified 1415 publications. This systematic review included 21 randomized controlled trials regarding acetylsalicylic acid, low-molecular-weight heparin, progesterone, intravenous immunoglobulin or leukocyte immune therapy in women with ≥3 consecutive miscarriages of unknown cause...
March 30, 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29602141/is-thromboprophylaxis-cost-effective-in-ovarian-hyperstimulation-syndrome-a-systematic-review-and-cost-analysis
#3
REVIEW
Kelly Comerford Wormer, Ayesha A Jangda, Farah A El Sayed, Katherine I Stewart, Sunni L Mumford, James H Segars
BACKGROUND: The majority of serious thromboembolic events occurring in assisted reproductive technologies (ART) are in women with ovarian hyperstimulation syndrome (OHSS). OBJECTIVES: The purpose of this study was to present a thorough review and cost analysis regarding the use of venous thromboembolism (VTE) prophylaxis in OHSS to inform clinical management. DATA SOURCES: Databases used were Pubmed and Embase, in addition to checking reference lists of retrieved articles (inception to November 2017)...
March 19, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29470181/prevention-and-management-of-thromboembolism-in-pregnancy-when-heparins-are-not-an-option
#4
Andra H James
Heparins, unfractionated heparin, and low molecular weight heparin, are the preferred anticoagulants in pregnancy. There are circumstances, however, in which an alternative to heparin should be considered. These circumstances include, the presence of heparin resistance, a heparin allergy manifesting as heparin-induced skin reactions or heparin-induced thrombocytopenia, and the presence of a mechanical heart valve. From time to time, the obstetrician is called on to make recommendations about anticoagulants in pregnancy, including in circumstances in which an alternative to heparin has been suggested or is necessary...
February 21, 2018: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29465258/administration-of-low-molecular-weight-heparin-in-patients-with-two-or-more-unsuccessful-ivf-icsi-cycles-a-multicenter-cohort-study
#5
Charalampos Siristatidis, Konstantinos Dafopoulos, George Salamalekis, George Galazios, Nikolaos Christoforidis, Theodoros Moustakarias, Nikoleta Koutlaki, Constantinos Bouschanetzis, Dimitrios Loutradis, Petros Drakakis
To compare the effects of the administration of low-molecular-weight heparin (LMWH) in subfertile patients with two or more unsuccessful IVF/ICSI cycles. In this six-center two-arm retrospective cohort study, the study population (230 women) underwent a GnRH-antagonist protocol and was classified into two groups, according to the couse of LMWH or not. Groups were compared regarding the clinical and IVF/ICSI cycle characteristics and reproductive outcomes, whereas clinical pregnancy and miscarriage constituted the primary endpoints...
February 21, 2018: Gynecological Endocrinology
https://www.readbyqxmd.com/read/29436886/anti-xa-based-dose-changes-during-low-molecular-weight-heparin-anticoagulation-for-mechanical-prosthetic-heart-valves-during-pregnancy
#6
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
#7
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
#8
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
#9
REVIEW
Karen Schreiber, Savino Sciascia, Philip G de Groot, Katrien Devreese, Soren Jacobsen, Guillermo Ruiz-Irastorza, 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
#10
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
#11
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
#12
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
#13
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...
February 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29222251/preventing-venous-thromboembolism-during-pregnancy-and-postpartum-crossing-the-threshold
#14
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
#15
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
#16
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...
December 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
#17
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
#18
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...
January 2018: 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
#19
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...
December 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
#20
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
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