Analysis of the role of low molecular weight heparin in preeclampsia and fetal growth restriction syndrome: A systematic review
DOI:
https://doi.org/10.56294/piii2024336Keywords:
Low Molecular Weight Heparin, Preeclampsia, Fetal Growth Restriction, Aspirin, Low DoseAbstract
Introduction: preeclampsia is defined as hypertension during pregnancy and this increase in blood pressure can lead to serious and unwanted decompensations for both the mother and the fetus. It has been shown that among the factors that lead to maternal death, PE ranks third, not being surpassed only by hemorrhages and thrombosis.
Objective: to determine the role of low molecular weight heparin in preeclampsia and fetal growth restriction syndrome.
Method: a systematic review of the literature was carried out addressing the analysis of the efficacy and safety of low molecular weight heparin in the treatment of preeclampsia. The articles were searched in the following databases such as Pubmed, Elsevier in the following languages: English, Spanish and Portuguese, from the last 20 years.
Results: 16 studies that met the inclusion criteria were included and 25,261 pregnant women were analyzed.
Conclusion: the analysis carried out shows that the efficacy of using LMWH in preeclampsia and fetal growth restriction syndrome can be an option in the treatment and prevention, however a great heterogeneity was detected in the results of the trials, which does not yet allow its use in medical practice
References
1. Álvarez Peralta TA, Tapia Cardenas J, Salazar Torres ZK. Prevalence and associated factors with hypertensive disorders of pregnancy in obstetric risk ages. Vicente Corral Moscoso Hospital, Cuenca 2019. Salud, Ciencia y Tecnología [Internet]. 2023 May 1 [cited 2024 Sep. 26];3:357. Disponible en: https://sct.ageditor.ar/index.php/sct/article/view/425
2. Guadalupe-Carrasco AL, Ramos-Ramírez MC. Importancia de la determinación de los niveles séricos de ácido úrico, colesterol y triglicéridos en mujeres embarazadas. Salud, Ciencia y Tecnología [Internet]. 27 de enero de 2024 [citado 26 de septiembre de 2024];4:747. Disponible en: https://sct.ageditor.ar/index.php/sct/article/view/865
3. Moreira Macías J, Bailón Mieles J, Bailón Mieles J. Maternal Pathologies Associated with Admission to the Intensive Care Unit. Salud, Ciencia y Tecnología [Internet]. 2024 Sep. 6 [cited 2024 Sep. 26];4:.604. Disponible en: https://sct.ageditor.ar/index.php/sct/article/view/604
4. Tenemaza Ortega KV, Cárdenas Heredia FR, Sánchez Peralta SM, Ordoñez Vázquez MJ. La hiperuricemia como predictor y herramienta de detección de preeclampsia. Salud, Ciencia y Tecnología [Internet]. 31 de diciembre de 2022 [consultado el 26 de septiembre de 2024];2:220. Disponible en: https://sct.ageditor.ar/index.php/sct/article/view/63
5. Kypshakbayeva Z, Kurmanova A, Kurmanova G, Salimbayeva D, Turekhanova A, Khalmyrsayeva M. Factores relacionados con el embarazo y predicción del accidente cerebrovascular periparto. Salud, Ciencia y Tecnología [Internet]. 7 de agosto de 2024 [citado el 26 de septiembre de 2024];4:1353. Disponible en: https://sct.ageditor.ar/index.php/sct/article/view/510
6. Brazolin Beltrão H, Gonçalves Reis Brito C, Costa Sousa D, Ferreira da Silva ME, Facina Brandão P, Alves dos Santos W. Principales diagnósticos e intervenciones de enfermería para el Síndrome de Hellp. Salud, Ciencia y Tecnología [Internet]. 24 de noviembre de 2022 [consultado el 26 de septiembre de 2024];2:106. Disponible en: https://sct.ageditor.ar/index.php/sct/article/view/38
7. Wu C. Ficacy and safety of low-dose aspirin combined with low-molecular-weight heparin in treatment of preeclampsia: a meta-analysis and systematic review. [Internet]. 2021 [citado 2024 Sep 25]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9710258/
8. Groom K. The role of aspirin, heparin, and other interventions in the prevention and treatment of fetal growth restriction. [Internet]. 2018 [citado 2024 Sep 25]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/29229321/
9. Cucurella NC. Anticoagulantes inyectables. Farmacia profesional. [Internet]. 2001 [citado 2024 Sep 25]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S2221-24502023000100112&lng=es&nrm=iso&tlng=es
10. Monica Cruz - L. Low-molecular-weight heparin for prevention of preeclampsia and other placenta-mediated complications: a systematic review and meta-analysis. [Internet]. 2021 [citado 2024 Sep 25]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/34301348/
11. Roberge S, Demers S, Nicolaides KH, Bureau M, Côté S, Bujold E. Prevention of pre-eclampsia by low-molecular-weight heparin in addition to aspirin: a meta-analysis. Ultrasound Obstet Gynecol. [Internet]. 2016 [citado 2024 Sep 25]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/26481090/
12. Guerby P, Fillion A, O'Connor S, Bujold E. Heparin for preventing adverse obstetrical outcomes in pregnant women with antiphospholipid syndrome, a systematic review and meta-analysis. [Internet]. 2021 [citado 2024 Sep 25]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33171281/
13. Ramos JGL, Sass N, Costa SHM. Preeclampsia. Pré-eclâmpsia. [Internet]. 2017 [citado 2024 Sep 25]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28793357/
14. Rodger MA, Langlois NJ, de Vries JI, et al. Low-molecular-weight heparin for prevention of placenta-mediated pregnancy complications: protocol for a systematic review and individual patient data meta-analysis (AFFIRM). [Internet]. 2014 [citado 2024 Sep 25]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/24969227/
15. Hamulyák EN, Scheres LJ, Marijnen MC, Goddijn M, Middeldorp S. Aspirin or heparin or both for improving pregnancy outcomes in women with persistent antiphospholipid antibodies and recurrent pregnancy loss. [Internet]. 2020 [citado 2024 Sep 25]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32358837/
16. Rahnemaei FA, Fashami MA, Abdi F, Abbasi M. Factors effective in the prevention of Preeclampsia:A systematic review. [Internet]. 2020 [citado 2024 Sep 25]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32127134/
17. McLaughlin K, Scholten RR, Parker JD, Ferrazzi E, Kingdom JCP. Low molecular weight heparin for the prevention of severe preeclampsia: where next?. [Internet]. 2018 [citado 2024 Sep 25]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5867115/
18. Wat JM, Baczyk D, Kingdom JC. The antithrombin binding regions of heparin mediate fetal growth and reduced placental damage in the RUPP model of preeclampsia†. [Internet]. 2020 [citado 2024 Sep 25]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31950133/
19. Huang J, Chen X, Xing H, et al. Aspirin and heparin for the prevention of pre-eclampsia: protocol for a systematic review and network meta-analysis. [Internet]. 2019 [citado 2024 Sep 25]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6443197/
20. Grimes S, Bombay K, Lanes A, Walker M, Corsi DJ. Potential biological therapies for severe preeclampsia: a systematic review and meta-analysis. [Internet]. 2019 [citado 2024 Sep 25]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31072315/
21. Leaf RK, Connors JM. The Role of Anticoagulants in the Prevention of Pregnancy Complications. [Internet]. 2017 [citado 2024 Sep 25]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/26566668/
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Maida Cristina Bertozzi de Miranda, Marcelo Adrián Estrin (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
The article is distributed under the Creative Commons Attribution 4.0 License. Unless otherwise stated, associated published material is distributed under the same licence.