Background: Despite the progress in understanding the pathogenesis of pre-eclampsia (PE), recurrent miscarriage and the progress in the clinical hemostasiology biology and pharmacology of new anticoagulants, antiplatelet agents, a study of their anticoagulant properties, the prevention and treatment of these «diseases of pregnancy» has not changed a lot.

Aims: To evaluate the role of antithrombotic therapy in adverse pregnancy outcomes.

Methods: We investigated 500 women with history of fetal loss syndrome, 80 – venous thromboembolism (VTE), 100 – placental abruption, including 10 patients with multiple pregnancies after IVF, 100 – the intrauterine fetal death, 160 – severe pre-eclampsia and 500 healthy women of the control group. Prevention of thromboses with LMWH was initiated since the fertile cycle and during pregnancy in all groups except in patients with pre-eclampsia diagnosed during pregnancy. The treatment included LMWH, the Omega-3 antioxidant, folic acid, B vitamins and low dose aspirin in patients with APS and platelet hyperactivity.

Results: Alive and healthy children were born in absolute majority of women with history of fetal loss syndrome (96%). After preventive therapy in patients with placental abruption, repeated events were not recorded and 100% of patients gave birth to live babies. No cases of severe or moderate pre-eclampsia were observed in the group of women with history of recurrent pre-eclampsia, who received the preventive treatment since the fertility cycle. Mild pre-eclampsia in a late period of the 3rd trimester developed in 16% of the women. The treatment initiated after the onset of pre-eclampsia, was ineffective. 48% of women developed mild pre-eclampsia and 52% showed deterioration of the disease with the development of severe pre-eclampsia.

Conclusions: Our studies and over 10 years of clinical experience indicate the presence of etiopathogenetic relation between thrombophilia and obstetric complications and the high efficacy of prophylaxis with anticoagulants when it starts early, since the period of preconception.

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/the-role-of-antithrombotic-therapy-in-the-prevention-of-adverse-pregnancy-outcomes/