Ormesher Laura, Simcox Louise, Tower Clare, Greer Ian A
Department of Obstetrics, St Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK Maternal and Fetal Health Research Centre, Institute of Human Development, University of Manchester, Manchester, UK
Department of Obstetrics, St Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK Maternal and Fetal Health Research Centre, Institute of Human Development, University of Manchester, Manchester, UK.
Womens Health (Lond). 2016 Jul;12(4):433-41. doi: 10.1177/1745505716653702.
Adverse pregnancy outcomes, such as pregnancy loss and pre-eclampsia, are associated with thrombotic mechanisms and thrombophilia. Antithrombotic interventions, particularly low-molecular-weight heparin, have been investigated in women identified by previous pregnancy outcome; however, the results have been inconsistent. This may reflect heterogeneity of both the study groups and the disease processes resulting in inadequate stratification to guide antithrombotic interventions. Furthermore, the variation in gestation at initiation of low-molecular-weight heparin treatment might be important. Despite limited evidence of efficacy, low-molecular-weight heparin is often used in an attempt to prevent these complications, owing to the lack of other effective treatments and its perceived safety in pregnancy. Research is required to better understand the disease processes, identify possible biomarkers and thereby more homogeneous groups for targeted treatment.
不良妊娠结局，如流产和子痫前期，与血栓形成机制和易栓症有关。抗血栓干预措施，尤其是低分子量肝素，已在既往有妊娠不良结局的女性中进行了研究；然而，结果并不一致。这可能反映了研究组和疾病过程的异质性，导致分层不足，无法指导抗血栓干预措施。此外，低分子量肝素治疗开始时的孕周差异可能也很重要。尽管疗效证据有限，但由于缺乏其他有效治疗方法以及其在孕期被认为的安全性，低分子量肝素常被用于预防这些并发症。需要开展研究以更好地了解疾病过程，确定可能的生物标志物，从而为靶向治疗确定更具同质性的群体。
