Low‐molecular‐weight heparin added to aspirin in the prevention of recurrent early‐onset pre‐eclampsia in women with inheritable thrombophilia: the FRUIT‐RCT

Vries, J.I.P. de; Pampus, Maria G. van; Hague, William; Bezemer, P.D.; Joosten, Johanna H. K.

doi:10.1111/j.1538-7836.2011.04553.x

Cited by 188 publications

(175 citation statements)

References 31 publications

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“…The hypercoagulability in pregnancy, this can in turn lead to complication like early onset hypertensive disorder of pregnancy [2] [15], that lead to decrease in natural anticoagulant and activation and increase in coagulation in early stage of fibrin clot formation, activated thrombin cleaves fibrinogen, soluble plasma protein convert immediately fibrin clot lead to micro vascular thrombi [15] [16].…”

Section: Discussionmentioning

confidence: 99%

Estimation of Plasma D-Dimer Levels in Sudanese Women with Preeclampsia

Abdelgadir¹,

Gaufri²

2017

OALib

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Background: The literature suggests that the haemostatic abnormalities have taken a big part in preeclampsia. D-dimer is a biomarker of fibrin formation and degradation. Objective: The present study was aimed to estimate and evaluation of the plasma D-dimer levels in Sudanese preeclampsia women. Material and Methods: This is an analytical descriptive case control study done during March 2016. A total of 100 participants were enrolled in this study, classified into two groups: the first group consisted of 50 Sudanese women diagnosed by preeclampsia as patients group, while the second group consisted of 50 normotensive women and their age matched to patients, designated as normal control group. 3 milliter of veins blood samples were collected in containers containing 3.2% tri sodium citrate as anticoagulant, then the platelet-poor plasma was prepared immediately by centrifuging for 15 minutes at approx 3000 rpm. The plasma D-dimer levels were done using MISPA-i2 (Switzerland). The data were analyzed by using SPSS (version 20). Results: The current study showed that the D-dimer level was statistically significant higher in preeclampsia women compared with normotensive pregnant women (Mean ± SD: 1.016 ± 0.158 vs 0.168 ± 0.045 with P value 0.000, respectively). Conclusion: This study concluded that the plasma D-dimer level was significantly elevated in Sudanese women with preeclampsia. Subject AreasHematology

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Section: Discussionmentioning

confidence: 99%

Estimation of Plasma D-Dimer Levels in Sudanese Women with Preeclampsia

Abdelgadir¹,

Gaufri²

2017

OALib

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“…Ressalta-se que todas as gestantes que receberam intervenção medicamentosa possuíam resultado positivo para a presença de trombofilias adquiridas e/ou hereditárias, fator que torna a população do presente estudo diferente da apresentada pela literatura, onde os estudos são conduzidos empiricamente, sem a confirmação laboratorial da presença de marcadores para trombofilias hereditárias e/ou adquiridas 11,13,29 .…”

Section: Discussionunclassified

“…Estudos disponíveis embasam-se em pequeno número de pacientes e com critérios para a seleção das pacientes muito divergentes [12][13][14] . Cabe ressaltar que o impacto da tromboprofilaxia com a heparina de baixo peso molecular (HBPM) e a história obstétrica prévia ainda necessitam ser esclarecidos, pois não existem grandes casuísticas sobre anticoagulação na gravidez, e as recomendações são baseadas em séries de casos e opiniões de especialistas 8,9,15,16 .…”

Section: Introductionunclassified

Eficácia de intervenção com enoxaparina baseada em sistema de pontuação nos desfechos perinatais de gestantes com trombofilias

Figueiró-Filho¹,

Oliveira²,

Breda³

et al. 2012

Rev. Bras. Ginecol. Obstet.

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ResumoOBJETIVO: Avaliar se a intervenção com heparina de baixo peso molecular (HBPM) -enoxaparina sódica -foi eficaz na melhora dos desfechos perinatais de mulheres com trombofillias com base em sistema de pontuação. MÉTODOS: Estudo prospectivo, não randomizado, não controlado, realizado em um Ambulatório de Gestação de Alto Risco, durante o período de novembro de 2009 a novembro de 2011. Foram incluídas gestantes com diagnóstico e intervenção terapêutica para trombofilias adquiridas e/ou hereditárias na gestação atual. Os dados obstétricos e perinatais das gestantes anteriores à intervenção foram comparados com os desfechos subsequentes à intervenção, sendo analisados estatisticamente através do teste do χ 2 , com correção de Yates, considerando significativos quando p<0,05. A dosagem inicial de HBPM foi norteada por sistema de pontuação, baseado no histórico clínico e gestacional das pacientes, além de exames de rastreamento de trombofilias adquiridas e/ou hereditárias. RESULTADOS: Foram incluídas 84 mulheres grávidas com 175 gestações anteriores ao diagnóstico, das quais 20,0% resultaram em morte fetal ou perinatal, 40,0% resultaram em abortamento, 17,7% desenvolveram pré-eclâmpsia ou eclâmpsia, 10,3% foram partos a termo e 29,7% partos pré-termo. Nas 84 gestações após a intervenção, 6,0% resultaram em morte fetal ou perinatal, 1,2% em abortamento, 4,8% desenvolveram pré-eclâmpsia/eclâmpsia, 22,6% em parto prematuro e 70,2% parto a termo. Observou-se redução significativa na taxa de óbito fetal ou perinatal (p<0,05) e abortos (p<0,0001), e aumento significativo (p<0,05) no número de nascidos vivos após a intervenção. CONCLUSÃO: A intervenção baseada na enoxaparina utilizando um sistema de pontuação em gestantes com trombofilia mostrou-se eficaz na melhora do desfecho perinatal. Abstract PURPOSES:To assess whether an enoxaparin-based intervention using a score system was effective in improving perinatal outcome in women with thrombophilia. METHODS: Study Design: Prospective, not randomized, uncontrolled, performed at a Clinic of High-Risk Pregnancy from November 2009 to November 2011. We included women with a diagnosis and therapeutic intervention for thrombophilia acquired and/or inherited in the current pregnancy. The obstetric and perinatal outcomes of pregnant women before the intervention were compared with outcomes after the intervention, and statistically analyzed using the χ 2 test with Yates correction, considered significant when p<0.05. The initial dose of low-molecular-weight Heparin (LMWH) was guided by a scoring system based on the clinical and gestational history of the patients and screening tests for acquired and/or inherited thrombophilia. RESULTS: We included 84 pregnant women with 175 pregnancies before diagnosis, 20.0% of which resulted in fetal ou perinatal death, 40.0% resulted in abortion, 17.7% developed preeclampsia/eclampsia, 10.3% resulted in full-term births, and 29.7% in premature births. In the 84 pregnancies after intervention, 6.0% resulted in fetal ou perinatal death, 1.2% in ...

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“…3,4,8,[10][11][12] It has also been seen that the treatment with LMWH has been preferred to unfractionated heparin. 3,4,8,11,[13][14][15][16][17][18][19][20] The recommendations for anticoagulation therapy for acquired thrombophilia are very well defined and have found to have a significant positive impact on pregnancy outcome. 2,4,8,12,15,22,23 Heparin is a glycosaminoglycan that binds to antithrombin thereby inactivating thrombin, Factor IXa and Factor Xa resulting in expression of anticoagulant response.…”

Section: Resultsmentioning

confidence: 99%

Obstetric outcome in pregnancy with thrombophilia: a comparative study of two different thromboprophylaxis regimes

Asthana

Sodhi

Kumar³

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Thrombophilia in pregnancy is a leading cause of both maternal and fetal mortality and morbidity. Thromboprophylaxis is administered to the patients with thrombophilia with an aim to improve the obstetric outcome. Although various studies have proven the benefits of treating pregnant women with thrombophilia, few studies comparing the usage of Unfractionated Heparin (UFH) and Low Molecular Weight Heparin (LMWH) along with low -dose ecosprin in terms of obstetric outcome, incidence of IUGR, pre-eclampsia, mode of delivery, neonatal birth weight and adverse effects of therapy have been published. This study was undertaken to compare two different treatment modalities using either UFH or LMWH (along with low dose ecosprin) in pregnant patients with thrombophilia with respect to obstetric outcomes and incidence of adverse effects of therapy. Methods: This randomised, prospective study was conducted in patients with a previous history of recurrent pregnancy losses or previous adverse pregnancy outcomes. Sixty patients diagnosed with thrombophilia were randomly divided into two groups of 30 patients each (Group I and II). Patients in Group I received Inj Unfractionated Heparin 5000 I.U. (s.c) twice daily and Tab Ecosprin 75 mg once daily and those in Group II received Inj LMWH (enoxaparin) 40 mg (s.c) once daily and Tab Ecosprin 75 mg once daily. These pregnancies were followed and the obstetrical outcome was determined. The data collected was analysed using the Student's `t`test and Chi-square test. P values < 0.05 were considered statistically significant. Results: There was no significant difference observed between two treatment groups with respect to pregnancy outcomes, incidence of IUGR, pre-eclampsia and mode of delivery (vaginal or by caesarean section). Treatment with a combination of LMWH and ecosprin administered to patients in Group II resulted in significantly higher neonatal birth weights. Conclusions: Treatment with a combination of LMWH and ecosprin resulted in significantly higher neonatal birth weights as compared to a regime that comprised of UFH and ecosprin. There was no significant difference seen in patients who were treated with either UFH or LMWH along with low dose ecosprin in terms of obstetric outcome, incidence of IUGR, pre-eclampsia and mode of delivery. No thromboembolic events or side effects were witnessed in patients subjected to either of the two regimes using LMWH or UFH with low dose ecosprin, thus, highlighting the safety of the antithrombotic therapy during pregnancy as used in this study.

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Low‐molecular‐weight heparin added to aspirin in the prevention of recurrent early‐onset pre‐eclampsia in women with inheritable thrombophilia: the FRUIT‐RCT

Cited by 188 publications

References 31 publications

Estimation of Plasma D-Dimer Levels in Sudanese Women with Preeclampsia

Estimation of Plasma D-Dimer Levels in Sudanese Women with Preeclampsia

Eficácia de intervenção com enoxaparina baseada em sistema de pontuação nos desfechos perinatais de gestantes com trombofilias

Obstetric outcome in pregnancy with thrombophilia: a comparative study of two different thromboprophylaxis regimes

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