Sokol Vesna, Ivanišević Marina, Herman Mislav, Đelmiš Josip
Acta Clin Croat. 2016 Jun;55(2):309-15. doi: 10.20471/acc.2016.55.02.19.
The aim of the study was to establish the importance of low molecular weight heparin (LMWH) treatment for good pregnancy outcome in patients with hereditary thrombophilia. This retrospective study included 70 patients with inherited thrombophilia who gave birth at Zagreb University Hospital Center in the period from January 2014 to January 2015. Fifty-seven women were treated and 13 women were not treated with LMWH. Perinatal outcome was significantly better in women with hereditary thrombophilia who were treated with heparin during pregnancy as compared with women without LMWH (p=0.006). Regardless of heparin therapy, patients with hereditary thrombophilia alone had a significantly better perinatal outcome as compared with women who, along with hereditary thrombophilia, had a history of habitual abortions (p=0.035) or intrauterine fetal death (p=0.033). Women treated with heparin had better perinatal outcome if they were without a history of recurrent or non-recurrent fetal loss (p=0.088). In the group without LMWH, perinatal outcome was significantly better in women with no history of habitual abortions as compared with women with recurrent miscarriages (p=0.047). Administration of LMWH is justified in women with hereditary thrombophilia and a history of adverse perinatal outcome.
本研究的目的是确定低分子量肝素（LMWH）治疗对遗传性血栓形成倾向患者获得良好妊娠结局的重要性。这项回顾性研究纳入了2014年1月至2015年1月期间在萨格勒布大学医院中心分娩的70例遗传性血栓形成倾向患者。57例女性接受了LMWH治疗，13例女性未接受LMWH治疗。与未接受LMWH治疗的女性相比，孕期接受肝素治疗的遗传性血栓形成倾向女性围产期结局明显更好（p = 0.006）。无论肝素治疗情况如何，单纯遗传性血栓形成倾向患者的围产期结局与合并遗传性血栓形成倾向且有习惯性流产史（p = 0.035）或胎儿宫内死亡史（p = 0.033）的女性相比明显更好。如果没有复发性或非复发性胎儿丢失史，接受肝素治疗的女性围产期结局更好（p = 0.088）。在未接受LMWH治疗的组中，与有复发性流产史的女性相比，无习惯性流产史的女性围产期结局明显更好（p = 0.047）。对于有遗传性血栓形成倾向且有不良围产期结局史的女性，给予LMWH治疗是合理的。
