Thrombosis Research
Volume 124, Issue 6 , Pages 653-655 , December 2009

Heparin and maternal fetal interface: Why should it work to prevent pregnancy complications?

  • Nazli Hossain

      Affiliations

    • Department of Obstetrics & Gynecology Unit 3, Civil Hospital & Dow University of Health Sciences, Karachi, Pakistan
    • Corresponding Author InformationCorresponding author.
    • ,
  • Frederick Schatz

      Affiliations

    • Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, 333 Cedar Street, FMB 339B, New Haven, CT 06520-8063, United States
    • ,
  • Michael J. Paidas

      Affiliations

    • Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, 333 Cedar Street, FMB 339B, New Haven, CT 06520-8063, United States
    • Yale Women and Children's Center for Blood Disorders, United States
    • National Hemophilia Foundation- Baxter Clinical Fellowship Program at Yale, United States
    • Division of Maternal Fetal Medicine, Yale University School of Medicine, 333 Cedar Street, FMB 339B, New Haven, CT 06520-8063, United States
    • Tel.: +1 203 737 1982; fax: +1 203 737 2327.

Received 28 July 2009 ,Revised 28 July 2009 ,Accepted 1 August 2009.

References 

  1. Challis JR, Lockwood CJ, Myatt L, Norman JE, Strauss JF, Petraglia F. Inflammation and pregnancy. Reprod Sci. 2009;16(2):206–215
  2. Park JS, Park CW, Lockwood CJ, Norwitz ER. Role of cytokines in preterm labor and birth. Minerva Ginecol. 2005;57(4):349–366
  3. Lok CA, Jebbink J, Nieuwland R, Faas MM, Boer K, Sturk A, et al. Leukocyte activation and circulating leukocyte-derived microparticles in preeclampsia. Am J Reprod Immunol. 2009;61(5):346–359
  4. Lockwood CJ. Pregnancy-associated changes in the hemostatic system. Clin Obstet Gynecol. 2006;49(4):836–843
  5. Halligan A, Bonnar J, Sheppard B, Darling M, Walshe J. Haemostatic, fibrinolytic and endothelial variables in normal pregnancies and pre-eclampsia. Br J Obstet Gynaecol. 1994;101(6):488–492
  6. Paidas MJ, Ku DH, Urban G, Hossain N, Rebarber A, Lockwood CJ, et al. Elevated first trimester soluble fibrin polymer is associated with adverse pregnancy outcome in thrombophilic patients. Blood Coagul Fibrinolysis. 2008;19(8):824–826
  7. Tyrell DJ, Kilfeather S, Page CP. Therapeutic uses of heparin beyond its traditional role as an anticoagulant. Trends Pharmacol Sci. 1995;16(6):198–204
  8. Salmon JE, Girardi G, Theodore E. Woodward Award: antiphospholipid syndrome revisited: a disorder initiated by inflammation. Trans Am Clin Climatol Assoc. 2007;118:99–114
  9. Mulla MJ, Brosens JJ, Chamley LW, Giles I, Pericleous C, Rahman A, et al. Antiphospholipid antibodies induce a pro-inflammatory response in first trimester trophoblast via the TLR4/MyD88, pathway. Am J Reprod Immunol. 2009;62(2):96–111
  10. Hills FA, Abrahams VM, Gonzalez-Timon B, Francis J, Cloke B, Hinkson L, et al. Heparin prevents programmed cell death in human trophoblast. Mol Hum Reprod. 2006;12(4):237–243
  11. Bose P, Black S, Kadyrov M, Weissenborn U, Neulen J, Regan L, et al. Heparin and aspirin attenuate placental apoptosis in vitro: implications for early pregnancy failure. Am J Obstet Gynecol. 2005;192(1):23–30
  12. Di Simone N, Di Nicuolo F, Sanguinetti M, Ferrazzani S, D'Alessio MC, Castellani R, et al. Low-molecular weight heparin induces in vitro trophoblast invasiveness: role of matrix metalloproteinases and tissue inhibitors. Placenta. 2007;28(4):298–304
  13. Gris JC, Dekker G, Cohen H. Antithrombotic prophylaxis for pregnancy loss Prothrombotic mechanisms in preeclampsia Inherited thrombophilia and pregnancy loss-epidemiology. Thromb Res. 2005;115(Suppl 1):30–32
  14. Paidas MJ, Ku DH, Lee MJ, Manish S, Thurston A, Lockwood CJ, et al. Protein Z, protein S levels are lower in patients with thrombophilia and subsequent pregnancy complications. J Thromb Haemost. 2005;3(3):497–501
  15. Riyazi N, Leeda M, de Vries JI, Huijgens PC, van Geijn HP, Dekker GA. Low-molecular-weight heparin combined with aspirin in pregnant women with thrombophilia and a history of preeclampsia or fetal growth restriction: a preliminary study. Eur J Obstet Gynecol Reprod Biol. 1998;80(1):49–54
  16. Sibai BM. Thrombophilia and severe preeclampsia: time to screen and treat in future pregnancies?. Hypertension. 2005;46(6):1252–1253
  17. Weiner Z, Beck-Fruchter R, Weiss A, Hujirat Y, Shalev E, Shalev SA. Thrombophilia and stillbirth: possible connection by intrauterine growth restriction. Bjog. 2004;111(8):780–783
  18. Kupferminc MJ, Fait G, Many A, Lessing JB, Yair D, Bar-Am A, et al. Low-molecular-weight heparin for the prevention of obstetric complications in women with thrombophilias. Hypertens Pregnancy. 2001;20(1):35–44
  19. Hossain N, Shamsi T, Soomro N. Frequency of thrombophilia in patients with adverse pregnancy outcome. J Pak Med Assoc. 2005;55(6):245–247
  20. Wu O, Robertson L, Twaddle S, Lowe GD, Clark P, Greaves M, et al. Screening for thrombophilia in high-risk situations: systematic review and cost-effectiveness analysis. The Thrombosis: Risk and Economic Assessment of Thrombophilia Screening (TREATS), study. Health Technol Assess. 2006;10(11):1–110
  21. Rey E, Garneau P, David M, Gauthier R, Leduc L, Michon N, et al. Dalteparin for the prevention of recurrence of placental-mediated complications of pregnancy in women without thrombophilia: a pilot randomized controlled trial. J Thromb Haemost. 2009;7(1):58–64
  22. Nelson SM, Greer IA. The potential role of heparin in assisted conception. Hum Reprod Update. 2008;14(6):623–645
  23. Qublan H, Amarin Z, Dabbas M, Farraj AE, Beni-Merei Z, Al-Akash H, et al. Low-molecular-weight heparin in the treatment of recurrent IVF-ET failure and thrombophilia: a prospective randomized placebo-controlled, trial. Hum Fertil (Camb). 2008;11(4):246–253
  24. Brenner B, Hoffman R, Carp H, Dulitsky M, Younis J. Efficacy and safety of two doses of enoxaparin in women with thrombophilia and recurrent pregnancy loss: the LIVE-ENOX, study. J Thromb Haemost. 2005;3:227–229(2%R doi:10.1111/j.1538-7836.2004.01090.x)
  25. Paidas M, Ku DH, Triche E, Lockwood C, Arkel Y. Does heparin therapy improve pregnancy outcome in patients with thrombophilias?. J Thromb Haemost. 2004;2(7):1194–1195
  26. Urban G, Vergani P, Tironi R, Ceruti P, Vertemati E, Sala F, et al. Antithrombotic prophylaxis in multiparous women with preeclampsia or intrauterine growth retardation in an antecedent pregnancy. Int J Fertil Womens Med. 2007;52(2-3):59–67
  27. Grandone E, De Stefano V, Rossi E, Cappucci F, Colaizzo D, Margaglione M. Antithrombotic prophylaxis during pregnancy in women with deficiency of natural anticoagulants. Blood Coagul Fibrinolysis. 2008;19(3):226–230
  28. Folkeringa N, Brouwer JL, Korteweg FJ, Veeger NJ, Erwich JJ, Holm JP, et al. Reduction of high fetal loss rate by anticoagulant treatment during pregnancy in antithrombin, protein C or protein S deficient women. Br J Haematol. 2007 Jul;138(1):110–116
  29. Duhl AJ, Paidas MJ, Ural SH, Branch W, Casele H, Cox-Gill J, et al. Antithrombotic therapy and pregnancy: consensus report and recommendations for prevention and treatment of venous thromboembolism and adverse pregnancy outcomes. Am J Obstet Gynecol. 2007;197(5):457 e1-21
  30. Rodger MA, Paidas M, Claire M, Middeldorp S, Kahn S, Martinelli I, et al. Inherited Thrombophilia and Pregnancy Complications Revisited. Obstet Gynecol. Aug 2008;112(2):320–324

PII: S0049-3848(09)00338-7

doi: 10.1016/j.thromres.2009.08.001

Thrombosis Research
Volume 124, Issue 6 , Pages 653-655 , December 2009

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