2019, Number 4
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Rev Cubana Hematol Inmunol Hemoter 2019; 35 (4)
Characterization of neonates of mothers with hypercoagulability in thromboprophylactic regimen
Castillo-González DC, Huerta-Perdomo S, Averhof-Hernández F, García-Sadovskaya I, Sidiki TA
Language: Spanish
References: 23
Page: 1-13
PDF size: 619.02 Kb.
ABSTRACT
Introduction: A decade ago, at the Institute of Hematology and Immunology, treatment of women with recurrent pregnancy losses due to hypercoagulability disorders began.
Objective: Clinically characterize these infants and identify the adverse effects of thromboprophylactic therapy in newborns.
Methods: A descriptive and transversal study was carried out between January 2014 and August 2017, which included 62 children of mothers with a diagnosis of thrombophilia who used during pregnancy, a thromboprophylaxis regimen with low molecular weight heparins and aspirin. All pregnant women were systematically evaluated in the Hemostasis and Obstetrics consultations of the Institute of Hematology and Immunology and Hospital Enrique Cabrera.
Results: The majority of the neonates were born at term, with normal apgar and weights above 2,500 g. 82.3% of pregnant women started thromboprophylaxis with less than 5 weeks of gestational age. There were significant differences when the weights of the infants of the mothers who started the treatment early were compared with those who started it late. The type of thrombophilia and maternal age did not influence the weights of the neonates, but those cases with more severe symptoms had children of lower weight, which although it was not significant, requires observation. No newborn presented side effects to thromboprophylactic therapy.
Conclusions: Infants born to mothers with thrombophilia who started thromboprophylaxis early were not different from those born to mothers without hypercoagulability.
REFERENCES
Almagro D. La hemostasia en las complicaciones obstétricas. La Habana: Ciencias Médicas; 1997.
Simcox LE, Ormesher L, Tower C, Greer IA. Thrombophilia and Pregnancy complications. Int J Mol Sci. 2015 Nov; 16(12):28418-28.
Middeldorp S. Is thrombophilia testing useful? Hematology Am Soc Hematol Educ Program. 2011;2011:150-5. doi: 10.1182/asheducation-2011.1.150.
Camarena-Cabrera DM, Rodriguez-Jaimes C, Acevedo-Gallegos S, Gallardo-Gaona JM, Velazquez-Torres B, Ramírez-Calvo JA. Controversias del síndrome de anticuerpos antifosfolipídicos en obstetricia. Reumatol Clin. 2017;13(1):30–6
Valdés-Armenteros R, Reyes-Izquierdo DM. Examen Clínico al Recién Nacido. La Habana: Ciencias Médicas; 2003.p.2-72.
Middeldorp S. New studies of low-molecular-weight heparin in pregnancy. Thromb Res. 2015;135 (Suppl 1):S26-9.
Martí-Sáez E. Trombofilia y Embarazo. Prevalencia de trombofilia y manejo terapéuticode mujeres con trombosis o complicaciones vasculares placentarias. Resultados del proyecto TEAM (trombosis en el ámbito de la mujer). [Tesis Doctoral]. Barcelona: Universidad Autónoma de Barcelona; 2016.
Castillo-González D, Rodríguez-Pérez L, Rodríguez-López R, García del Collado A, Tejeda- González M. Seguimiento de gestante con síndrome de plaquetas pegajosas: primer caso comunicado en Cuba. Revista Cubana de Hematología, Inmunología y Hemoterapia [revista en Internet]. 2015 [citado 2017Oct 4]; 31(4): [aprox. 0 p.]. Disponible en: http://www.revhematologia.sld.cu/index.php/hih/article/view/383
Visser J, Ulander VM, Helmerhorst FM, Lampinen K, Morin-Papunen L, Bloemenkamp KW, et al. Thromboprophylaxis for recurrent miscarriage in women with or without thrombophilia. HABENOX: A randomized multicentre trial. Thromb Haemost. 2011;105(2):295–301.
Croles FN, Nasserinejad K, Duvekot JJ, JHA Kruip MJ, Meijer K, Leebeek FW. Pregnancy, thrombophilia, and the risk of a first venous thrombosis: systematic review and bayesian meta-analysis. BMJ. 2017;359:j4452.
Kupferminc MJ, Many A, Bar-Am A, Lessing JB, Ascher Landsberg J. Mid trimester severe intrauterine growth restriction is associated with a high prevalence of thrombophilia. BJOG. 2002; 109:1373-6.
Villar I, Ruiz-Irastorza G. Tratamiento del síndrome antifosfolipídico en el embarazo. Semin Fund Esp Reumatol. 2006;7:59-69.
Grandone E, Margaglione M, Colaizzo D, Pavone G, Paladini D, Martinelli P, et al. Lower birth-weight in neonates of mothers carrying factor V G1691A and factor II A20210 mutations. Haematologica. 2002; 87:177-81.
Cetin O, Karaman E, Cim N, Dirik D, Sahin HG, Kara E, Esen R. The impact of low molecular weight heparin on obstetric outcomes among unexplained recurrent miscarriages complicated with methylenetetrahydrofolate reductase gene polymorphism. Ginekol Pol. 2017;88(5):260-5.
Guzmán León AI. Efecto del tratamiento anticoagulante en la evolución del embarazo en mujeres con trombofilia hereditaria [Tesis doctoral]. Málaga: Universidad de Málaga; 2017.
Middeldorp S. New studies of low-molecular-weight heparin in pregnancy. Thromb Res. 2015 Feb;135(Suppl 1): S26-9.
Bouvier S, Cochery-Nouvellon E, Lavigne Lissalde G, Mercier E, Marchetti T, Balducchi JP, et al. Comparative incidence of pregnancy outcomes in treated obstetric antiphospholipid syndrome: the NOH-APS observational study. Blood. 2014, 16(123):404-13.
Kupferminc MJ, Many A, Bar-Am A, Lessing JB, Ascher Landsberg J. Mid trimester severe intrauterine growth restriction is associated with a high prevalence of thrombophilia. BJOG. 2002;109:1373-6.
Verspycka E, Le Cam-Duchezb V, Goffinetc F, Trond F, Marpeaua L, Borg YJ. Thrombophilia and immunological disorders in pregnancies as risk factors for small for gestational age infants. BJOG. 2002;109:28–33.
Pasquier E, de Saint Martin L, Bohec C, Chauleur C, Bretelle F, Marhic G et al. Enoxaparin for prevention of unexplained recurrent miscarriage: a multicenter randomized double-blind placebo-controlled trial. Blood. 2015 Apr;125(14):2200–5
Merviel P, Cabry R, Lourdel E, Lanta S, Amant C, Copin H et al. Comparison of two preventive treatments for patients with recurrent miscarriages carrying a C677T methylenetetrahydrofolate reductase mutation: 5-year experience. J Int Med Res. 2017;45(6): 1720–30.
Duffet L, Rodger M. LMWH to prevent placenta-mediated pregnancy complications: aupdate. BJH. 2015;168:619-38.
Areia AL, Fonseca E, Areia M, Moura P. Low molecular-weight heparin plus aspirin versus aspirin alone in pregnant women with hereditary thrombophilia to improve live birth rate: meta-analysis of randomized controlled trials. Arch Gynecol Obstet. 2016;293(1):81-6.