Does Thromboprophylaxis During Pregnancy Lower Risk for Adverse Outcomes?

Allison Bryant, MD, MPH

Antepartum dalteparin did not improve obstetric outcomes in women with thrombophilia.

Genetic and acquired thrombophilias have been associated with adverse pregnancy outcomes and venous thromboembolism (VTE) during pregnancy and postpartum. Now, researchers have conducted an international, randomized, controlled trial to examine whether antepartum treatment with dalteparin, a low-molecular-weight heparin (LMWH), can lower risks for VTE, severe preeclampsia, small-for-gestational-age births, or pregnancy loss in women with thrombophilia and histories of adverse pregnancy events or high risk for VTE.

In all, 292 participants were randomized to no treatment or LMWH from <21 weeks' gestation through delivery. Neither the incidence of the primary composite outcome nor any of its components differed between groups; however, minor bleeding events were more common in the LMWH group (20% vs. 9%; P=0.01).

Citation(s):

Rodger MA et al. Antepartum dalteparin versus no antepartum dalteparin for the prevention of pregnancy complications in pregnant women with thrombophilia (TIPPS): A multinational open-label randomised trial. Lancet 2014 Jul 25; [e-pub ahead of print].