Preventing adverse obstetric outcomes in women with genetic thrombophilia

Objective: To improve fetomaternal outcomes in women with obstetric complications and inherited causes of thrombophilia. Design: Clinical trial. Setting: Thrombophilic women with previous unexplained adverse outcomes. Patient(s): Twenty-five women with previous severe obstetric complications were treated during and after pregnancy. Intervention(s): Low fixed dose of heparin or aspirin. Main Outcome Measure(s): Fetomatemal outcome. Result(s): Low fixed dose of heparin were administered to 24 pregnant women, aspirin to 7. Overall, among 31 treated pregnant women, 28 (90.3%) compared to 4 of 58 (6.9%) in previous pregnancies had a good obstetric outcome. Two fetal losses <14 weeks gestation and a fetal growth restriction were registered. All newborns, except one, were in the tenth centile or above. All babies were discharged in good clinical status. In the treated pregnancies, no thrombosis or pharmacological side effect was recorded. Conclusion(s): Heparin prophylaxis at fixed low doses and possibly aspirin could be efficacious in preventing adverse outcomes in women carrying inherited thrombophilia with previous poor obstetric outcomes.