Thrombosis Program, Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
Br J Haematol. 2015 Mar;168(5):619-38. doi: 10.1111/bjh.13209. Epub 2014 Nov 15.
Placenta-mediated pregnancy complications, including preeclampsia, placental abruption, intrauterine growth restriction/small for gestational age and recurrent or late pregnancy loss, affect over 5% of pregnancies and can result in significant maternal and perinatal morbidity and mortality. These complications have been suggested to at least partly arise from placental insufficiency, possibly as a result of inappropriate coagulation activation. This association has led to the hypothesis that anticoagulant therapy, such as low molecular weight heparin, might reduce their occurrence. The following review will attempt to summarize the extensive research that has been performed to date exploring this hypothesis and provide guidance on the current and future role of low molecular weight heparin in women at risk for placenta-mediated pregnancy complications. A case will be made to question the widely adopted practice of prescribing low molecular weight heparin to women with prior placenta-mediated pregnancy complications and suggest possible areas for future research.
胎盘介导的妊娠并发症，包括子痫前期、胎盘早剥、胎儿宫内生长受限/小于胎龄儿和复发性或晚期妊娠丢失，影响了超过 5%的妊娠，并可导致严重的母亲和围产期发病率和死亡率。这些并发症至少部分被认为是由于胎盘功能不全引起的，可能是由于凝血激活不当所致。这种关联导致了这样一种假设，即抗凝治疗，如低分子量肝素，可能会降低它们的发生。以下综述将试图总结迄今为止为探索这一假设所进行的广泛研究，并就低分子量肝素在有胎盘介导的妊娠并发症风险的妇女中的当前和未来作用提供指导。将质疑广泛采用的对有胎盘介导的妊娠并发症史的妇女开低分子量肝素的做法，并提出未来研究的可能领域。
