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Blood, 15 May 2004, Vol. 103, No. 10, pp. 3695-3699. Prepublished online as a Blood First Edition Paper on January 22, 2004; DOI 10.1182/blood-2003-12-4250. This Article Full Text (PDF) All Versions of this Article: 2003-12-4250v1 103/10/3695    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by GRIS, J.-C. Articles by MARES, P. Search for Related Content PubMed PubMed Citation Articles by GRIS, J.-C. Articles by MARES, P. Related Collections Related Article in Blood Online Related Letter in Blood Online Social Bookmarking                   What's this? Submitted December 12, 2003 Accepted January 20, 2004 Low molecular weight heparin versus low-dose aspirinin women with one fetal loss and a constitutional thrombophilic disorder Jean-Christophe GRIS*, Eric MERCIER, Isabelle QUERE, Geraldine LAVIGNE-LISSALDE, Eva COCHERY-NOUVELLON, Mederic HOFFET, Sylvie RIPART-NEVEU, Marie-Laure TAILLAND, Michel DAUZAT, and Pierre MARES Hematology Laboratory, University Hospital, Nimes, France; Hematology Laboratory, University of Montpellier 1, Montpellier, France; Equipe d'Acceuil 2992, University of Montpellier 1, Nimes, France Hematology Laboratory, University Hospital, Nimes, France Equipe d'Acceuil 2992, University of Montpellier 1, Nimes, France Hematology Laboratory, University Hospital, Nimes, France; Hematology Laboratory, University of Montpellier 1, Montpellier, France Department of Gynecology and Obstetrics, University Hospital, Nimes, France * Corresponding author; email: jcgris{at}chu-nimes.fr. The prospective evaluation of the effect of thromboprophylaxis in women with one unexplained pregnancy loss from the 10th week of amenorrhoea was performed: 160 patients, with heterozygous factor V Leiden mutation, prothrombin G20210A mutation, or protein S deficiency, were given 5 mg folic acid daily before conception, to be continued during pregnancy, and low-dose aspirin, 100 mg daily or low-molecular weight heparin enoxaparin, 40mg, were taken from the 8th week. Twenty three of the 80 patients treated with low-dose aspirin and 69 of the 80 patients treated with enoxaparin had a normal live birth (OR 15.5, 95%CI 7-34, p<0.0001). Enoxaparin was superior to low-dose aspirin in each subgroup defined according to the underlying constitutional thrombophilic disorder. An associated protein Z deficiency, and/or positive anti-protein Z antibodies, were associated with poorer outcomes. The neonate weight was higher in the women successfully treated with enoxaparin and neonates small for gestational age were more frequent in patients treated with low-dose aspirin. No significant side-effects of the treatments could be evidenced in patients or newborns. As there is no argument to prove that low-dose aspirin may had been deleterious, these results support enoxaparin use during such at-risk pregnancies. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Improving pregnancy outcome in women with thrombophilia Benjamin Brenner Blood 2004 103: 3609. [Full Text] [PDF] Related Letter in Blood Online: Important publication missing key information Marc Rodger, Jean-Christophe Gris, Isabelle Quéré, Michel Dauzat, and Pierre Marès Blood 2004 104: 3413-3414. [Full Text] [PDF] This article has been cited by other articles: A. H. James Venous Thromboembolism in Pregnancy Arterioscler Thromb Vasc Biol, March 1, 2009; 29(3): 326 - 331. [Abstract] [Full Text] [PDF] P. S. GIBSON and R. POWRIE Anticoagulants and pregnancy: When are they safe? Cleveland Clinic Journal of Medicine, February 1, 2009; 76(2): 113 - 127. [Abstract] [Full Text] [PDF] S. M. Nelson and I. A. Greer The potential role of heparin in assisted conception Hum. Reprod. Update, November 1, 2008; 14(6): 623 - 645. [Abstract] [Full Text] [PDF] S. M. Bates, I. A. Greer, I. Pabinger, S. Sofaer, and J. Hirsh Venous Thromboembolism, Thrombophilia, Antithrombotic Therapy, and Pregnancy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition) Chest, June 1, 2008; 133(6_suppl): 844S - 886S. [Abstract] [Full Text] [PDF] R. Sood, M. Zogg, R. J. Westrick, Y.-h. Guo, E. J. Kerschen, G. Girardi, J. E. Salmon, S. R. Coughlin, and H. Weiler Fetal gene defects precipitate platelet-mediated pregnancy failure in factor V Leiden mothers J. Exp. Med., May 14, 2007; 204(5): 1049 - 1056. [Abstract] [Full Text] [PDF] S. M. Bates Management of Pregnant Women with Thrombophilia or a History of Venous Thromboembolism Hematology, January 1, 2007; 2007(1): 143 - 150. [Abstract] [Full Text] [PDF] J.-C. Gris Trophoblast cells sense maternal hemostasis Blood, April 15, 2006; 107(8): 3019 - 3020. [Full Text] [PDF] B. M. Sibai Thrombophilia and Severe Preeclampsia: Time to Screen and Treat in Future Pregnancies? Hypertension, December 1, 2005; 46(6): 1252 - 1253. [Full Text] [PDF] I. A. Greer and C. Nelson-Piercy Low-molecular-weight heparins for thromboprophylaxis and treatment of venous thromboembolism in pregnancy: a systematic review of safety and efficacy Blood, July 15, 2005; 106(2): 401 - 407. [Abstract] [Full Text] [PDF] L. Carbillon, S. Uzan, and B. Brenner Early treatment with low-dose aspirin is effective for the prevention of preeclampsia and related complications in high-risk patients selected by the analysis of their historic risk factors Blood, January 15, 2005; 105(2): 902 - 903. [Full Text] [PDF] M. Rodger, J.-C. Gris, I. Quere, M. Dauzat, and P. Mares Important publication missing key information Blood, November 15, 2004; 104(10): 3413 - 3414. [Full Text] [PDF]

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