对有子痫前期或前次妊娠胎儿宫内生长受限的经产妇进行抗血栓预防。

Antithrombotic prophylaxis in multiparous women with preeclampsia or intrauterine growth retardation in an antecedent pregnancy.

作者信息

Urban Gabriele, Vergani Patrizia, Tironi Roberta, Ceruti Patrizia, Vertemati Emanuela, Sala Francesca, Pogliani Enrico, Triche Elizabeth W, Lockwood Charles J, Paidas Michael J

机构信息

University of Milano-Bicocca, Department of Obstetrics and Gynecology, Italy.

出版信息

Int J Fertil Womens Med. 2007 Mar-Jun;52(2-3):59-67.

PMID:18320863

Abstract

OBJECTIVE

To determine whether prophylactic low dose aspirin (LDA) alone or in combination with low-molecular-weight-heparin (LMWH) reduces the recurrence of adverse pregnancy outcome (APO).

STUDY DESIGN

In this retrospective cohort study, 84 consecutive multiparous patients with a previous history of severe preeclampsia (sPE) and intrauterine growth restriction (IUGR) (<10%ile) were assigned to receive no treatment, LDA alone, or LDA and LMWH. Odds ratios were calculated from logistic regression models.

RESULTS

Combined LDA and LMWH significantly reduced the risk of developing IUGR in the index pregnancy (OR = 0.16, 95% CI: 0.03-0.98). Among women with antecedent sPE (n=52), combined treatment reduced APO in the index pregnancy (OR = 0.08, CI: 0.01-0.96), IUGR (OR = 0.02, CI: <0.01-0.46), and IUGR with sPE (OR = 0.08, CI: 0.01-0.96).

CONCLUSION

Combined treatment with LDA and LMWH is strongly protective against the development of APO in a cohort of women with antecedent APO.

摘要

目的

确定单独使用预防性低剂量阿司匹林（LDA）或联合低分子量肝素（LMWH）是否能降低不良妊娠结局（APO）的复发率。

研究设计

在这项回顾性队列研究中，84例有重度子痫前期（sPE）和宫内生长受限（IUGR）（<第10百分位数）病史的经产妇被分配接受不治疗、单独使用LDA或LDA与LMWH联合治疗。比值比由逻辑回归模型计算得出。

结果

LDA与LMWH联合使用显著降低了本次妊娠发生IUGR的风险（OR = 0.16，95% CI：0.03 - 0.98）。在有既往sPE的女性（n = 52）中，联合治疗降低了本次妊娠的APO（OR = 0.08，CI：0.01 - 0.96）、IUGR（OR = 0.02，CI：<0.01 - 0.46）以及合并sPE的IUGR（OR = 0.08，CI：0.01 - 0.96）。