Abstract Number: PB2523
Meeting: ISTH 2020 Congress
Background: Our earlier prospective cohort study which included 140 women with the prothrombin G20210A mutation reported that prothrombin activity can be considered as a predictive marker for the development of preeclampsia (PE). When plasma prothrombin activity is >171% at the preconception stage, the risk of PE is predicted in 86% of cases (AUС-0.863; p< 0.0001), when prothrombin activity is >181,0% at the gestational age of 7-8 weeks, it is predicted in 84% of cases (AUС-0.840; p< 0.0001). The absence of studies aimed at examining the benefit of low molecular weight heparin (LMWH) administration due to the high prothrombin activity in carriers of the prothrombin G20210A mutation to prevent gestational complications was the reason for this study.
Aims: To determine the effect of LMWH on the prevention of preeclampsia and fetal growth restriction (FGR) since the preconception period in carriers of the prothrombin G20210A mutation with an increased suprathreshold prothrombin activity.
Methods: A single-center randomized controlled trial of 80 pregnant women with the prothrombin G20210A mutation was conducted. The criterion for inclusion into the study was the plasma prothrombin activity >171% at the preconception stage. The study group consisted of 50 patients received weight-adjusted heparin prophylaxis since the fertile cycle (Figure 1). The control group included 30 pregnant women who did not receive LMWH prophylaxis.
Results: Analysis of pregnancy outcomes showed that the use of nadroparin calcium in prophylactic doses in carriers of the prothrombin G20210A genotype with a prothrombin activity level >171% at the preconception stage reduces the absolute risk of PE by 46.7% (p=0.0001), including a severe form by 30.7% (p=0.0001) and FGR by 30.7% (p=0.0001).
Conclusions: In carriers of the prothrombin G20210A genotype with a prothrombin activity level >171%, LMWH administration is pathogenetically justified and leads to a significant reduction in the number of gestational complications.
To cite this abstract in AMA style:Nikolaeva M, Momot A, Zainulina M, Yasafova N. Low Molecular Weight Heparins in the Prevention of Placenta-Mediated Complications in Carriers of the Prothrombin G20210A Mutation [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/low-molecular-weight-heparins-in-the-prevention-of-placenta-mediated-complications-in-carriers-of-the-prothrombin-g20210a-mutation/. Accessed November 28, 2021.
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