Low molecular weight heparin and aspirin exacerbate human endometrial endothelial cell responses to antiphospholipid antibodies

Quao, Zola Chihombori; Tong, Mancy; Bryce, Elena; Guller, Seth; Chamley, Lawrence W.; Abrahams, Vikki M.

doi:10.1111/aji.12785

Cited by 19 publications

(18 citation statements)

References 77 publications

(132 reference statements)

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“…Antiphospholipid syndrome: high levels of antiphospholipid antibodies and history of miscarriages and/or endometrial death and/or thrombosis-risk of autoimmune in subsequent pregnancy ~90% [46,47].…”

Section: Autoimmune Factorsmentioning

confidence: 99%

“…Steroids (complications: pregnancy and prematurity) are not recommend based on current publication evidence. It is reported that the maternal and fetal complications increase without affecting the pregnancy outcome and live births [43][44][45][46][47].…”

Section: Antiphospholipid Syndrome: Managementmentioning

confidence: 99%

“…At discontinuance after around 32 weeks, heparin (does not pass the placenta) should be started after the first positive pregnancy test and should be continued until of labor to avoid thrombosis risk: hypo-heparin, for example, heparin of low molecular weight, one injection daily. Anticoagulant action (reinforces the action of antithrombin III), while it may bind AFAs, thus prevents chorionic villus sampling (CVS) phospholipids from being destroyed, by assisting in the successful implantation in the early stages of pregnancy [43][44][45][46][47]. Thrombocytopenia and osteoporosis check-up.…”

Section: Prednisolone Between 10 and 20 Mg Daily Dosagementioning

confidence: 99%

“…It appears that combining aspirin and heparin has the best results. Patients should start taking heparin as early as possible when pregnant and continue until labor and during puerperium [42][43][44][45][46][47][48][49][50]. Combination of aspirin and heparin is associated with better results.…”

Section: Prednisolone Between 10 and 20 Mg Daily Dosagementioning

confidence: 99%

“…Heparin subcutaneously, for example, low molecular weight heparin one injection per day may prevent recycling of circulating anti-cardiolipins or suppress the secretion of embryotoxic agents or HLA-related agents. It also reduces the percentage of NK (CD56+/CD16+) cells [46][47][48][49][50]. It has been associated with gestational hypertension and diabetes mellitus and mainly with premature labor and low birth weight neonates.…”

Section: Prednisolone Between 10 and 20 Mg Daily Dosagementioning

confidence: 99%

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Abortions in First Trimester Pregnancy, Management, Treatment

Tsikouras¹,

Deftereou²,

Anthoulaki³

et al. 2020

Induced Abortion and Spontaneous Early Pregnancy Loss - Focus on Management

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The miscarriages' investigation should include a familiar history, gynecological examination and a full laboratory testing including hormonal control, as well as karyotype, maternal immune control and thrombophilia testing. If the physician suspects the cause of abortions is chromosomal due to heredity, a special blood test (karyotype) for the pair is recommended. Chromosomal abnormalities are the most common reason for first trimester abortions, and are impossible to be prevented. Based on the above data, abortion and the subsequent possible infertility should not be considered as a personal failure for the woman and the treating physician. Nowadays, medical advancement provides many options combined with psychological support can actually reduce the miscarriages' risk.

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Section: Autoimmune Factorsmentioning

confidence: 99%

Section: Antiphospholipid Syndrome: Managementmentioning

confidence: 99%

Section: Prednisolone Between 10 and 20 Mg Daily Dosagementioning

confidence: 99%

Section: Prednisolone Between 10 and 20 Mg Daily Dosagementioning

confidence: 99%

Section: Prednisolone Between 10 and 20 Mg Daily Dosagementioning

confidence: 99%

See 3 more Smart Citations

Abortions in First Trimester Pregnancy, Management, Treatment

Tsikouras¹,

Deftereou²,

Anthoulaki³

et al. 2020

Induced Abortion and Spontaneous Early Pregnancy Loss - Focus on Management

View full text Add to dashboard Cite

show abstract

Aspirin or heparin or both for improving pregnancy outcomes in women with persistent antiphospholipid antibodies and recurrent pregnancy loss

Hamulyák

Scheres

Marijnen

et al. 2020

Cochrane Database of Systematic Reviews

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Does low-dose aspirin initiated before 11 weeks’ gestation reduce the rate of preeclampsia?

Chaemsaithong

Cuenca-Gomez

Plana

et al. 2020

American Journal of Obstetrics and Gynecology

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Condensation: Aspirin given at <11 weeks' gestation in high risk women does not reduce the risk of preeclampsia and gestational hypertension but may reduce the risk of preterm delivery. Short title: Early aspirin administration and preeclampsia PROSPERO registration number: CRD42019125006 AJOG at a Glance: Why was this study conducted? • To perform a systematic review and meta-analysis to evaluate the effect of lowdose aspirin initiated at <11 weeks' gestation on the risk of preeclampsia, gestational hypertension, or any hypertensive disorder of pregnancy. Secondary outcomes included preterm delivery at <37 weeks' gestation and fetal growth restriction. Key findings • The administration of low-dose aspirin at <11 weeks' gestation in women with a history of recurrent pregnancy loss, women who had undergone in vitro fertilization or women with thrombophilia or antiphospholipid syndrome was associated with a non-significant decrease in the risk of preeclampsia, gestational hypertension, and any hypertensive disorder of pregnancy. • Early low-dose aspirin reduced the risk of preterm delivery but had no impact on the risk of fetal growth restriction. • Except for preterm delivery and any hypertensive disorder of pregnancy, sensitivity analysis demonstrated similar observations; confirming the robustness of our analysis. What does this add to what is known? • Administration of low-dose aspirin at <11 weeks' gestation to high risk women does not reduce the risk of preeclampsia, gestational hypertension, any hypertensive disorder of pregnancy and fetal growth restriction but might reduce the risk of preterm delivery at <37 weeks of gestation. ABSTRACT OBJECTIVE DATA: Pre-conception or early administration of low-dose aspirin might improve endometrial growth, placental vascularization and organogenesis. Most studies have evaluated the potential benefit of pre-conception or early administration of low-dose aspirin in women with a history of recurrent pregnancy loss, women who have undergone in vitro fertilization or women with thrombophilia or antiphospholipid syndrome. These women are at an increased risk of placenta-associated complications of pregnancy, including preeclampsia, preterm delivery and fetal growth restriction. STUDY: We performed a systematic review and meta-analysis to evaluate the effect of low-dose aspirin initiated at <11 weeks' gestation on the risk of preeclampsia, gestational hypertension, or any hypertensive disorder of pregnancy. Secondary outcomes included preterm delivery at <37 weeks' gestation and fetal growth restriction. STUDY APPRAISAL AND SYNTHESIS METHODS: We searched in MEDLINE via PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.Gov and the World Health Organization International Clinical Trials Registry Platform (WHO-ICTRP) from 1985 to November 2018. Entry criteria were randomized controlled trials evaluating the effect of aspirin administered at <11 weeks' gestation in preventing preeclampsia and/or hypertensive disorders in pregnancy or improvi...

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Low molecular weight heparin and aspirin exacerbate human endometrial endothelial cell responses to antiphospholipid antibodies

Abstract: By aPL inhibiting HEEC chemokine secretion and promoting sFlt-1 release, the uterine endothelium may contribute to impaired placentation and vascular transformation. LMWH and ASA may further contribute to endothelium dysfunction in women with obstetric APS.

Cited by 19 publications

References 77 publications

Abortions in First Trimester Pregnancy, Management, Treatment

Abortions in First Trimester Pregnancy, Management, Treatment

Aspirin or heparin or both for improving pregnancy outcomes in women with persistent antiphospholipid antibodies and recurrent pregnancy loss

Does low-dose aspirin initiated before 11 weeks’ gestation reduce the rate of preeclampsia?

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