Influence of anti-coagulant therapy in the first trimester uterine flow indices

Abstract

Abstract Purpose: to explore the impact of anticoagulants (aspirin and/or low molecular weight heparin (LMWH)) in the uterine artery flow at 11-13 weeks of gestation. Materials and Methods: retrospective study on singleton viable pregnancies presenting for routine 11-13 weeks’ ultrasound scan. Maternal and fetal variables were assessed as to their influence on uterine artery pulsatility index (UtA-PI). Results: 5,606 pregnancies were analyzed. Increasingmaternal age, higher BMI, large fibroids and higher PAPP-A levels were associated with lower Ut-A PI, whereas history of pre-eclampsia/hypertension in a previous pregnancy, smoking and increased fetal ductus venosus PI were associated with higher Ut-A PI levels. The strongest effect was exerted by history of PET/hypertension, maternal PAPP-A MoM and fetal ductus venosus PI. Anticoagulant treatment had no significant influence. Conclusion: prior treatment with aspirin and/or LMWH does not alter the Ut-A PI. Screening models for pre-eclampsia can be used in women receiving anti-coagulant therapy.