Prophylactic Heparin May Not Prevent Placental Insufficiency

Unfractionated heparin offers no advantage to standard care for risk of placental insufficiency

MONDAY, June 27 (HealthDay News) -- Women at risk of placental insufficiency who are treated with unfractionated heparin (UFH) during pregnancy may not have significantly better outcomes than those undergoing standard care, according to a study published online June 20 in the Journal of Thrombosis and Haemostasis.

John C.P. Kingdom, M.D., of the University of Toronto, and colleagues investigated the efficacy of UFH treatment in 32 women at high-risk of placental insufficiency in the second trimester. Thrombophilia screen-negative women, with either false-positive first- or second-semester serum tests or other medical/obstetric risk factors, were randomly allocated to receive 7500 IU UFH twice daily until birth or 34 weeks' gestation (16 women) or standard care. Sonography of the placenta and uterine artery Doppler were performed between 18 and 22 weeks. Maternal-infant outcomes, including maternal anxiety, were evaluated.

The investigators found no statistically major difference between the standard care group and the UFH group in the mean anxiety score, birth weight, perinatal death, severe preeclampsia, placental weight below the 10th percentile, or placental infarction.

"Our study design and findings, including placental pathology data, challenge the widely prevailing view that pregnant women should receive prophylactic heparin to improve perinatal outcomes based solely on clinical risk factors for placental insufficiency," the authors write.

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