Preeclampsia and pregnancy loss in women with a history of venous thromboembolism and prophylactic low-molecular-weight heparin (LMWH) during pregnancy

Guelay Alguel; Rainer Vormittag; Ralph Simanek; Paul A. Kyrle; Peter Quehenberger; Christine Mannhalter; Peter Husslein; Ingrid Pabinger

doi:10.1160/TH06-03-0165

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2006; 96(03): 285-289
DOI: 10.1160/TH06-03-0165

Theme Issue Article

Schattauer GmbH

Preeclampsia and pregnancy loss in women with a history of venous thromboembolism and prophylactic low-molecular-weight heparin (LMWH) during pregnancy

Authors

Guelay Alguel

¹Department of Internal Medicine I, Vienna, Austria
Rainer Vormittag

¹Department of Internal Medicine I, Vienna, Austria
Ralph Simanek

¹Department of Internal Medicine I, Vienna, Austria
Paul A. Kyrle

¹Department of Internal Medicine I, Vienna, Austria
Peter Quehenberger

²Clinical Institute of Medical and Chemical Laboratory Diagnostics, Vienna, Austria
Christine Mannhalter

²Clinical Institute of Medical and Chemical Laboratory Diagnostics, Vienna, Austria
Peter Husslein

³Department of Obstetrics and Gynecology, Medical University Vienna; Vienna, Austria
Ingrid Pabinger

¹Department of Internal Medicine I, Vienna, Austria

Abstract

Summary

Limited data are available regarding complications of pregnancy and pregnancy outcome under prophylaxis with low-molecular-weight heparin (LMWH) in women with a history of thromboembolism (TE).We retrospectively evaluated pregnancy complications ina cohort of 80 women. All hada history of TE (76 venous, two arterial and two venous and arterial) and received prophylactic LMWH during 86 pregnancies. The rate of preeclampsia and stillbirth in these women was compared to that of a control group of 313 women without a history of TE and LMWH. Prophylaxis was started at a median of 10 weeks of gestation and usually continued until six weeks post partum. In 94% of the cases the outcome of pregnancy was favourable with a live birth. Four pregnancies (4.7%) ended in miscarriage. Two (2.3%) pregnancies were complicated bya thromboembolic event (one deep leg vein thrombosis and PRIND, respectively). One patient developed HELLP-syndrome. Severe preeclampsia occurred in three (3.8%) and stillbirth in one (1.3%) of the patients (n=80), whereas this was the case in four (1.3%, odds ratio 3.01; 95% confidence interval (CI) 0.66–13.73, p=0.15) and 10 (3.2%, OR=0.38; 95% CI 0.05–3.04, p=0.72) control women. Mean birth weight and standard deviation of infants was 3,160± 930 g in patients and 3,300 ± 540 g in controls (p=0.11).We conclude that a favourable pregnancy outcome in women with a history of thromboembolism who use prophylactic LMWH during pregnancy can be expected. There was a trend towardsa higher risk of preeclampsia, and these women should be carefully monitored for this complication.

Keywords

Low-molecular-weight heparin - history of VTE - pregnancy loss - preeclampsia

Full Text

References

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