The physiologic anticoagulant and anti-inflammatory role of heparins and their utility in the prevention of pregnancy complications

Salvatore Andrea Mastrolia; Moshe Mazor; Gershon Holcberg; Elad Leron; Ofer Beharier; Giuseppe Loverro; Offer Erez

doi:10.1160/TH14-10-0848

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2015; 113(06): 1236-1246
DOI: 10.1160/TH14-10-0848

Review Article

Schattauer GmbH

The physiologic anticoagulant and anti-inflammatory role of heparins and their utility in the prevention of pregnancy complications

Authors

Salvatore Andrea Mastrolia

¹Department of Obstetrics and Gynecology, Azienda Ospedaliera-Universitaria Policlinico di Bari, School of Medicine, University of Bari “Aldo Moro”, Bari, Italy

²Obstetrics and Gynecology, Soroka University Medical Center, School of Medicine, Ben Gurion University of the Negev, Beer Sheva, Israel
Moshe Mazor

²Obstetrics and Gynecology, Soroka University Medical Center, School of Medicine, Ben Gurion University of the Negev, Beer Sheva, Israel
Gershon Holcberg

²Obstetrics and Gynecology, Soroka University Medical Center, School of Medicine, Ben Gurion University of the Negev, Beer Sheva, Israel
Elad Leron

²Obstetrics and Gynecology, Soroka University Medical Center, School of Medicine, Ben Gurion University of the Negev, Beer Sheva, Israel
Ofer Beharier

²Obstetrics and Gynecology, Soroka University Medical Center, School of Medicine, Ben Gurion University of the Negev, Beer Sheva, Israel
Giuseppe Loverro

¹Department of Obstetrics and Gynecology, Azienda Ospedaliera-Universitaria Policlinico di Bari, School of Medicine, University of Bari “Aldo Moro”, Bari, Italy
Offer Erez

²Obstetrics and Gynecology, Soroka University Medical Center, School of Medicine, Ben Gurion University of the Negev, Beer Sheva, Israel

Abstract

Summary

Accumulating evidence supports the concept of increased thrombin generation, placental vascular lesions, and inflammation as crucial points in the development of the great obstetrical syndromes [preeclampsia, intrauterine growth restriction (IUGR), preterm labor (PTL), preterm prelabor rupture of membranes (PROM), fetal demise and recurrent abortions]. In light of this, the role of heparins for primary or secondary prevention of these syndromes is becoming more and more apparent, mainly due to the antithrombotic and anti-inflammatory effects of heparins. There is agreement regarding the use of heparin in the prevention of gestational complications in patients with antiphospholipid syndrome, while its use for other obstetrical complications is under debate. In the present review we will describe the physiologic role of heparins on coagulation and inflammation and we will discuss current evidence regarding the use of heparins for the prevention/ treatment of obstetrical syndromes.

Keywords

Antiphospholipid syndrome - inflammation - preterm labour - recurrent pregnancy loss - thrombin generation

Full Text

References

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