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Low molecular weight heparin pregnancy

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https://www.readbyqxmd.com/read/29222251/preventing-venous-thromboembolism-during-pregnancy-and-postpartum-crossing-the-threshold
#1
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
#2
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...
December 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29169973/-maternal-death-by-venous-thromboembolic-disease
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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...
September 26, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/28826740/the-effect-of-parnaparin-sodium-on-in-vitro-fertilization-outcome-a-prospective-randomized-controlled-trial
#11
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
#12
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
https://www.readbyqxmd.com/read/28737308/a-multicentre-study-of-thromboprophylaxis-in-pregnancy
#13
M P Crowley, C Noone, J R Higgins, S O'Shea
Venous thromboembolism (VTE) is a leading cause of maternal mortality. The risk increases with increasing maternal age, mode of delivery and medical co-morbidities. Thromboprophylaxis with low molecular weight heparin (LMWH) has been shown to be both safe and efficacious. The aim of this study was to prospectively investigate the incidence of maternal risk factors in pregnant women admitted to hospital, to calculate their VTE risk status and to investigate if they were receiving appropriate thromboprophylaxis...
May 10, 2017: Irish Medical Journal
https://www.readbyqxmd.com/read/28683785/mesenteric-cysts-and-mesenteric-venous-thrombosis-leading-to-intestinal-necrosis-in-pregnancy-managed-with-laparotomy-a-case-report-and-review-of-the-literature
#14
Aris Giannos, Sofoklis Stavrou, Nikolaos Goumalatsos, George Fragkoulidis, Eleni Chra, Dimitrios Argiropoulos, Dimitrios Loutradis, Peter Drakakis
BACKGROUND: Mesenteric cyst is a rare clinical entity especially in pregnancy; therefore, few cases have been reported in the literature. The standard method of their treatment is surgical excision either with laparotomy or laparoscopy. In addition, mesenteric vein thrombosis is a rare and life-threatening condition in pregnancy and needs immediate treatment because it can lead to intestinal necrotic ischemia. This is the first report of the coexistence of mesenteric cysts and mesenteric vein thrombosis during gestation...
July 7, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28667866/a-case-that-illustrates-the-challenges-of-managing-pregnant-patients-with-antithrombin-deficiency-more-questions-than-answers
#15
Leslie Skeith, Andrew Aw, Julia Hews-Girard, Natalia Rydz
Using an illustrative case of a patient with antithrombin (AT) deficiency who developed a recurrent venous thromboembolism (VTE) in pregnancy despite therapeutic low-molecular-weight heparin (LMWH), we highlight what is known in the literature and address areas of controversy through a series of questions around the case. The questions we address include the role of anti-Xa monitoring for patients with past VTE on antepartum LMWH, what treatment regimen is recommended for pregnant patients who develop a recurrent VTE while on therapeutic anticoagulation, the role of antepartum AT concentrate prophylaxis, and the management of labor/delivery, epidural anesthesia and postpartum anticoagulation...
June 24, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28618257/is-a-therapeutic-anticoagulation-window-needed-for-delivery-when-using-prophylactic-low-molecular-weight-heparin-during-pregnancy-a-retrospective-monocentric-study
#16
Assila Roueli, Elsa Cesario, Julien Amsellem, Antoine Agman, Danièle Vauthier-Brouzes, Jacky Nizard
OBJECTIVES: The aim of the study was to evaluate the usefulness of therapeutic window for delivery for patients under prophylactic anticoagulation by low molecular weight heparin (LMWH) by comparing those who had a planned delivery versus those who delivered spontaneously. STUDY DESIGN: This retrospective monocentric study included pregnant patients with prophylactic anticoagulation (one injection per day of enoxaparin 4000UI), who delivered after 24 weeks of gestation...
August 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28580572/the-impact-of-low-molecular-weight-heparin-on-obstetric-outcomes-among-unexplained-recurrent-miscarriages-complicated-with-methylenetetrahydrofolate-reductase-gene-polymorphism
#17
Orkun Cetin, Erbil Karaman, Numan Cim, Deniz Dirik, Hanim Guler Sahin, Erdal Kara, Ramazan Esen
OBJECTIVES: The association between methylenetetrahydrofolate reductase gene polymorphisms and unexplained recurrent miscarriage is elusive. The recommendations for improving pregnancy outcomes in these patients keep changing based on the available evidence. The aim of this study is to analyze the impact of low molecular weight heparin on obstetric outcomes of recurrent miscarriage patients complicated with methylenetetrahydrofolate reductase gene polymorphism. MATERIAL AND METHODS: We reviewed medical records of 121 patients with a history of recurrent miscarriage complicated by methylenetetrahydrofolate reductase gene polymorphisms, retrospectively...
2017: Ginekologia Polska
https://www.readbyqxmd.com/read/28578446/unilateral-adrenal-infarction-in-pregnancy-secondary-to-elevated-factor-viii
#18
Khaled Y Aljenaee, Sulaiman A Ali, Seong K Cheah, Moudhi J Alroomi
Adrenal infarction in pregnancy is an extremely rare event. We report a case of a 29-year-old pregnant woman at the twenty-fourth week of gestation that presented with an acute episode of severe localized right upper quadrant pain. Her preliminary blood investigations and abdominal ultrasonography were essentially unremarkable. A diagnosis of right adrenal infarction was subsequently established on the basis of a non-enhanced swollen right adrenal gland on CT scanning of the abdomen with contrast, consistent with the clinical presentation...
June 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28571631/maternal-and-fetal-outcomes-of-anticoagulation-in-pregnant-women-with%C3%A2-mechanical-heart%C3%A2-valves
#19
REVIEW
Zachary L Steinberg, Clara P Dominguez-Islas, Catherine M Otto, Karen K Stout, Eric V Krieger
BACKGROUND: Anticoagulation for mechanical heart valves during pregnancy is essential to prevent thromboembolic events. Each regimen has drawbacks with regard to maternal or fetal risk. OBJECTIVES: This meta-analysis sought to estimate and compare the risk of adverse maternal and fetal outcomes in pregnant women with mechanical heart valves who received different methods of anticoagulation. METHODS: Studies were identified using a Medline search including all publications up to June 5, 2016...
June 6, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28506952/retrospective-evaluation-of-pregnant-women-with-celiac-disease
#20
Kemal Beksaç, Gökçen Örgül, Murat Çağan, Ergun Karaağaoğlu, Serap Arslan, Mehmet Sinan Beksaç
OBJECTIVE: To show celiac disease (CD) and its poor pregnancy outcome relationship, and to demonstrate the importance of a gluten-free diet together with low-dose low-molecular-weight heparin (LMWH) and low-dose corticosteroid (LDC) in the management of pregnancies with CD. MATERIAL AND METHODS: This study consisted of 2 groups of patients. Six patients with CD (control group) on a gluten-free diet were monitored during their first pregnancies within the framework of antenatal care program and their pregnancy outcomes were compared with eight poorly-treated pregnant patients with CD (study group) who were referred from other medical institutions...
March 15, 2017: Journal of the Turkish German Gynecological Association
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