Low molecular weight heparin prophylaxis for placenta-mediated complications in women with F2G20210A mutation-Reference-Cited by-同舟云学术

Low molecular weight heparin prophylaxis for placenta-mediated complications in women with F2G20210A mutation

Published:2021-09-02 Issue:2 Volume:66 Page:231-241
ISSN:2411-3042
Container-title:Russian journal of hematology and transfusiology
language:
Short-container-title:Gematologiâ i transfuziologiâ

Author:

Nikolaeva M. G.¹^ORCID,Yasafova N. N.²^ORCID,Momot A. P.¹^ORCID,Zainulina M. S.³^ORCID,Taranenko I. A.²^ORCID

Affiliation:

1. Altai State Medical University; Altai Branch of the National Research Center for Hematology

2. Altai Territorial Clinical Hospital

3. Maternity Hospital No. 6 named after Prof. V.F. Snegirev; Pavlov First Saint-Petersburg State Medical University

Abstract

Introduction. A prothrombin-mutant genotype is a known risk factor in gestational complications.Aim — efficacy assessment in pregravid heparin prevention of pre-eclampsia (PE) and foetal growth retardation (FGR) in females with F2G20210A genotype and suprathreshold prothrombin activity.Patients and methods. A single-centre randomised controlled study enrolled 80 pregnant women carrying prothrombin F2G20210A. The inclusion criterion was a pregravid plasma prothrombin activity > 171 %. The study cohort consisted of 50 women (mean age 31.2 ± 3.7 years) receiving low molecular-weight heparin (LMWH) in menstrual cycle at weight-based elevated prevention doses. A comparison group comprised 30 pregnant women (mean age 31.3 ± 2.9 years) not receiving LMWH prophylaxis.Results. A pregravid start of LMWH treatment at high prophylactic doses in F2G20210A genotype carriers with prothrombin activity > 171 % allowed an absolute risk reduction (ARR) of PE by 46.7 % [p = 0.0001; number needed to treat (NNT): 2.1; 95 % confidence interval (CI) 3.4–1.56], severe PE by 30.7 % [p = 0.0001; NTT: 3.3; 95 % CI (6.7–2.2)] and FGR by 30.7 % [p = 0.0001; NTT: 3.3; 95 % CI (6.7–2.2)].Conclusion. Use of LMWH is justified in prevention of placenta-mediated complications in F2G20210A genotype carriers with a suprathreshold-high prothrombin activity.

Publisher

National Medical Research Center of Hematology of the Ministry of Health of the Russian Federation

Subject

Hematology

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