Does low-molecular-weight heparin improve live birth rates in pregnant women with thrombophilic disorders? A systematic review
Singapore medical journal
;
: 659-663, 2012.
Artigo
em Inglês
| WPRIM
| ID: wpr-249644
ABSTRACT
<p><b>INTRODUCTION</b>Pregnancies in women with thrombophilia are associated with a higher risk of obstetric complications. We systematically reviewed the findings of relevant randomised controlled trials (RCTs) with the aim of investigating the effectiveness of low-molecular-weight heparins (LMWHs) in pregnant women with inherited thrombophilic disorders and its effect on the incidence of live births in these patients.</p><p><b>METHODS</b>The MEDLINE-PubMed and Cochrane CENTRAL databases from 2000 to 2010 were searched using a combination of keywords, including low-molecular-weight heparin, enoxaparin, pregnancy, live birth and thrombophilia. Studies were included if they were RCTs assessing the effect of anticoagulant treatment on live birth rates in women with a history of miscarriage without apparent causes other than thrombophilic disorder. Interventions included LMWH, with or without aspirin, aspirin alone or placebo controlled for the prevention of adverse pregnancy outcome.</p><p><b>RESULTS</b>43 articles with seven RCTs were retrieved following the initial search, of which four studies had to be excluded as they assessed thromboembolic events as the final outcome (n = 1), focused on idiopathic recurrent miscarriages (n = 1), compared efficacy and safety of two doses of enoxaparin (n = 1), and examined patients with or without thrombophilic disorder (n = 1). Pooled data from the remaining three RCTs showed no significant difference in the improvement of live birth rates following LMWH interventions (p = 0.15).</p><p><b>CONCLUSION</b>At present, the use of LMWH in women with inherited thrombophilia with recurrent pregnancy loss is not indicated. Large randomised placebo-controlled trials are further needed to prove the effectiveness of LMWH in these patients.</p>
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Complicações Hematológicas na Gravidez
/
Resultado da Gravidez
/
Resultado do Tratamento
/
Heparina de Baixo Peso Molecular
/
Trombofilia
/
Usos Terapêuticos
/
Tratamento Farmacológico
Tipo de estudo:
Ensaio Clínico Controlado
/
Revisões Sistemáticas Avaliadas
Limite:
Feminino
/
Humanos
/
Gravidez
Idioma:
Inglês
Revista:
Singapore medical journal
Ano de publicação:
2012
Tipo de documento:
Artigo
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