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Study: LMWH for women w/o thrombophilias

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Study: LMWH for women w/o thrombophilias

Postby kerisue » Thu Jan 06, 2011 00:41 am

I just noticed this and wondered if anyone had thoughts on it? I don't have any thrombophilias, but not sure about the pathological placenta, have to double check my records for that one. My doc has said no to the lovenox (in a future pregnancy) since I don't have a diagnosed thrombophilia, but this makes me wonder if I should push it.

http://www.ncbi.nlm.nih.gov/pubmed/21192252

Low molecular weight heparin versus no treatment in women with previous severe pregnancy complications and placental findings without thrombophilia.Low molecular weight heparin (LMWH) treatment has been recommended for pregnant women with previous adverse pregnancy and who were diagnosed as having a thrombophilia. We now examined the effect of LMWH on pregnant women without thrombophilias who had severe pregnancy complications and placental vasculopathy in an earlier pregnancy......[skip to the conclusion]:Treatment with LMWH may reduce the rate of the recurrence of severe pregnancy complications and significant placental vasculopathy in women without thrombophilias.
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born June 2010 @ 24 wks. gestation due to my severe PE and CHF
lived 25 days, loved and missed
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Re: Study: LMWH for women w/o thrombophilias

Postby angieb » Thu Jan 06, 2011 10:20 pm

I met with 2 different MFM practices and they were totally mixed on it. One wouldn't do it because there was not enough significant research to support it and they wouldn't do anything without research, the other thought we should try it, but would have been okay if I'd nixed it too. (In addition to HELLP, we had severe IUGR at 23 weeks, like 4 weeks behind, and at my last ultrasound they could see reverse bloodflow.) I ultimately decided that it was a risk I wanted to take, although I'll probably be off of it totally by around 30 weeks if everything is going well, so far we've had no issues with the lovenox and the baby's actually measuring ahead this time. We'll never know if it was even the lovenox (and LDA) that helped or just being a subsequent pregnant helped or just a new placenta, but I didn't want to regret not doing it. If your current MFM doesn't agree to it and you decide you want to do it, it probably wouldn't be that difficult to find an MFM who would okay it.
Me (29) DH (30)
#1-Olivia Caetlyn-9-28-09-9-28-09, 23+2 wks, emergency classic c-section, class I HELLP, IUGR
#2- Lucas Oliver (rainbow baby)- April 2011, 36+2 wks, HELLP and pre-e free! (lovenox and LDA pregnancy)
#3-Matthew, late October 2012...mostly normal, 37 wks, (lovenox and LDA again)
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Re: Study: LMWH for women w/o thrombophilias

Postby rosalinda » Fri Jan 07, 2011 01:40 pm

I used the lovenox for my 2nd pregnancy which ended in miscarriage, didn't use it for my 3rd and delivered at 36 wks. BUT the placental report came back that the placenta was small for age and had infarcts. The same report as with my 1st pregnancy. So were I to get pregnant again, this time I think I'll ask for both the lovenox & LDA.
-Elissa, January 2007: stillborn at 25 weeks, severe PE, IUGR, reverse-end diastolic flow
- Chronic hypertension as of November 2007
-missed miscarriage Feb 2009
- Ismael Jaden, June 2010, 36 wks, oligohydramnios & rising BP's, my wonderful little man & the love of my life
- Janelle, September 2011, 24wks, 3days. complete placental abruption & DIC, stillborn
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Re: Study: LMWH for women w/o thrombophilias

Postby kerisue » Sat Jan 15, 2011 12:09 am

I showed this abstract to a well regarded MFM specialist yesterday and he was lukewarm on it. He didn't have high regard for the researchers and said the journal it was published in is somewhat obscure. Even with this new info he would not recommend Lovenox for me, which is pretty much in line with what every other doctor I've seen has said.
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born June 2010 @ 24 wks. gestation due to my severe PE and CHF
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