Thromboprophylaxis and pregnancy outcomes in asymptomatic women with inherited thrombophilias
Objective Our objective was to evaluate the effect of thromboprophylaxis on pregnancy outcomes in asymptomatic women with inherited thrombophilias. Study Design This was a retrospective cohort study of asymptomatic pregnant women with inherited thrombophilias. Medical records were reviewed for pregn...
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| Veröffentlicht in: | American journal of obstetrics and gynecology 2009-03, Vol.200 (3), p.281.e1-281.e5 |
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| container_title | American journal of obstetrics and gynecology |
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| creator | Warren, Jennifer E., MD Simonsen, Sara E., RN, MSPH Branch, D. Ware, MD Porter, T. Flint, MD, MSPH Silver, Robert M., MD |
| description | Objective Our objective was to evaluate the effect of thromboprophylaxis on pregnancy outcomes in asymptomatic women with inherited thrombophilias. Study Design This was a retrospective cohort study of asymptomatic pregnant women with inherited thrombophilias. Medical records were reviewed for pregnancy events, diagnosis of thrombophilias, and management in subsequent pregnancies. Outcomes in women who were and were not treated with thromboprophylaxis were compared using Fisher's exact test and logistic regression. Results Fifty-three women had 75 pregnancies subsequent to their diagnosis of thrombophilia. Women treated with heparin had similar rates of live births (86% vs 82%; P = .8, Fisher's exact test) as those not treated. The odds ratio of live birth in all pregnancies for women treated with heparin was compared with untreated women and was 1.9 (95% confidence interval, 0.5-6.3). Conclusion Pregnancy outcomes are often good in asymptomatic women with thrombophilias in the absence of treatment. Treatment of these women during pregnancy should be considered investigational. |
| doi_str_mv | 10.1016/j.ajog.2008.10.021 |
| format | Article |
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Ware, MD ; Porter, T. Flint, MD, MSPH ; Silver, Robert M., MD</creator><creatorcontrib>Warren, Jennifer E., MD ; Simonsen, Sara E., RN, MSPH ; Branch, D. Ware, MD ; Porter, T. Flint, MD, MSPH ; Silver, Robert M., MD</creatorcontrib><description>Objective Our objective was to evaluate the effect of thromboprophylaxis on pregnancy outcomes in asymptomatic women with inherited thrombophilias. Study Design This was a retrospective cohort study of asymptomatic pregnant women with inherited thrombophilias. Medical records were reviewed for pregnancy events, diagnosis of thrombophilias, and management in subsequent pregnancies. Outcomes in women who were and were not treated with thromboprophylaxis were compared using Fisher's exact test and logistic regression. Results Fifty-three women had 75 pregnancies subsequent to their diagnosis of thrombophilia. Women treated with heparin had similar rates of live births (86% vs 82%; P = .8, Fisher's exact test) as those not treated. The odds ratio of live birth in all pregnancies for women treated with heparin was compared with untreated women and was 1.9 (95% confidence interval, 0.5-6.3). Conclusion Pregnancy outcomes are often good in asymptomatic women with thrombophilias in the absence of treatment. Treatment of these women during pregnancy should be considered investigational.</description><identifier>ISSN: 0002-9378</identifier><identifier>EISSN: 1097-6868</identifier><identifier>DOI: 10.1016/j.ajog.2008.10.021</identifier><identifier>PMID: 19114274</identifier><identifier>CODEN: AJOGAH</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Adult ; Anticoagulants - therapeutic use ; Biological and medical sciences ; Cohort Studies ; Female ; Gynecology. Andrology. Obstetrics ; Hematologic and hematopoietic diseases ; Heparin - therapeutic use ; Humans ; Logistic Models ; Medical sciences ; Obstetrics and Gynecology ; Platelet diseases and coagulopathies ; Pregnancy ; Pregnancy Complications - diagnosis ; Pregnancy Complications - prevention & control ; Pregnancy Outcome ; pregnancy outcomes ; Retrospective Studies ; thrombophilia ; Thrombophilia - diagnosis ; Thrombophilia - drug therapy ; thromboprophylaxis ; Treatment Outcome ; Young Adult</subject><ispartof>American journal of obstetrics and gynecology, 2009-03, Vol.200 (3), p.281.e1-281.e5</ispartof><rights>Mosby, Inc.</rights><rights>2009 Mosby, Inc.</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c439t-226b349788e0ce9901d9a6fa0fc218afcfd244a18a1fbd1c21274503b846015e3</citedby><cites>FETCH-LOGICAL-c439t-226b349788e0ce9901d9a6fa0fc218afcfd244a18a1fbd1c21274503b846015e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002937808020346$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21207448$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19114274$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Warren, Jennifer E., MD</creatorcontrib><creatorcontrib>Simonsen, Sara E., RN, MSPH</creatorcontrib><creatorcontrib>Branch, D. Ware, MD</creatorcontrib><creatorcontrib>Porter, T. Flint, MD, MSPH</creatorcontrib><creatorcontrib>Silver, Robert M., MD</creatorcontrib><title>Thromboprophylaxis and pregnancy outcomes in asymptomatic women with inherited thrombophilias</title><title>American journal of obstetrics and gynecology</title><addtitle>Am J Obstet Gynecol</addtitle><description>Objective Our objective was to evaluate the effect of thromboprophylaxis on pregnancy outcomes in asymptomatic women with inherited thrombophilias. Study Design This was a retrospective cohort study of asymptomatic pregnant women with inherited thrombophilias. Medical records were reviewed for pregnancy events, diagnosis of thrombophilias, and management in subsequent pregnancies. Outcomes in women who were and were not treated with thromboprophylaxis were compared using Fisher's exact test and logistic regression. Results Fifty-three women had 75 pregnancies subsequent to their diagnosis of thrombophilia. Women treated with heparin had similar rates of live births (86% vs 82%; P = .8, Fisher's exact test) as those not treated. The odds ratio of live birth in all pregnancies for women treated with heparin was compared with untreated women and was 1.9 (95% confidence interval, 0.5-6.3). Conclusion Pregnancy outcomes are often good in asymptomatic women with thrombophilias in the absence of treatment. Treatment of these women during pregnancy should be considered investigational.</description><subject>Adult</subject><subject>Anticoagulants - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Heparin - therapeutic use</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Medical sciences</subject><subject>Obstetrics and Gynecology</subject><subject>Platelet diseases and coagulopathies</subject><subject>Pregnancy</subject><subject>Pregnancy Complications - diagnosis</subject><subject>Pregnancy Complications - prevention & control</subject><subject>Pregnancy Outcome</subject><subject>pregnancy outcomes</subject><subject>Retrospective Studies</subject><subject>thrombophilia</subject><subject>Thrombophilia - diagnosis</subject><subject>Thrombophilia - drug therapy</subject><subject>thromboprophylaxis</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0002-9378</issn><issn>1097-6868</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUGP1SAUhYnROG9G_4AL043u-rxQpoXEmEwmjppM4sJxaQilt1NqWypQx_57aV6jiQtXwOHcw-W7hLygcKRAyzf9Uffu_sgARBKOwOgjcqAgq7wUpXhMDgDAcllU4oych9BvRybZU3JGJaWcVfxAvt113o21m72bu3XQv2zI9NRks8f7SU9mzdwSjRsxZHbKdFjHObpRR2uyh6RO2YONXbrq0NuITRb3uM4OVodn5Emrh4DP9_WCfL15f3f9Mb_9_OHT9dVtbnghY85YWRdcVkIgGJQSaCN12WpoDaNCt6ZtGOc6bWlbNzSJqfdLKGrBS6CXWFyQ16fc9I0fC4aoRhsMDoOe0C1BlaWUtOKQjOxkNN6F4LFVs7ej9quioDaoqlcbVLVB3bQENRW93NOXesTmb8lOMRle7QYdjB5an8DZ8MeX2oWKc5F8b08-TCx-WvQqGIuTwcZ6NFE1zv6_j3f_lJvBTja9-B1XDL1b_JQoK6oCU6C-bPPepg8CGBS8LH4Dn9Cr6A</recordid><startdate>20090301</startdate><enddate>20090301</enddate><creator>Warren, Jennifer E., MD</creator><creator>Simonsen, Sara E., RN, MSPH</creator><creator>Branch, D. Ware, MD</creator><creator>Porter, T. Flint, MD, MSPH</creator><creator>Silver, Robert M., MD</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20090301</creationdate><title>Thromboprophylaxis and pregnancy outcomes in asymptomatic women with inherited thrombophilias</title><author>Warren, Jennifer E., MD ; Simonsen, Sara E., RN, MSPH ; Branch, D. Ware, MD ; Porter, T. Flint, MD, MSPH ; Silver, Robert M., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c439t-226b349788e0ce9901d9a6fa0fc218afcfd244a18a1fbd1c21274503b846015e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adult</topic><topic>Anticoagulants - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Hematologic and hematopoietic diseases</topic><topic>Heparin - therapeutic use</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Medical sciences</topic><topic>Obstetrics and Gynecology</topic><topic>Platelet diseases and coagulopathies</topic><topic>Pregnancy</topic><topic>Pregnancy Complications - diagnosis</topic><topic>Pregnancy Complications - prevention & control</topic><topic>Pregnancy Outcome</topic><topic>pregnancy outcomes</topic><topic>Retrospective Studies</topic><topic>thrombophilia</topic><topic>Thrombophilia - diagnosis</topic><topic>Thrombophilia - drug therapy</topic><topic>thromboprophylaxis</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Warren, Jennifer E., MD</creatorcontrib><creatorcontrib>Simonsen, Sara E., RN, MSPH</creatorcontrib><creatorcontrib>Branch, D. Ware, MD</creatorcontrib><creatorcontrib>Porter, T. Flint, MD, MSPH</creatorcontrib><creatorcontrib>Silver, Robert M., MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of obstetrics and gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Warren, Jennifer E., MD</au><au>Simonsen, Sara E., RN, MSPH</au><au>Branch, D. Ware, MD</au><au>Porter, T. Flint, MD, MSPH</au><au>Silver, Robert M., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Thromboprophylaxis and pregnancy outcomes in asymptomatic women with inherited thrombophilias</atitle><jtitle>American journal of obstetrics and gynecology</jtitle><addtitle>Am J Obstet Gynecol</addtitle><date>2009-03-01</date><risdate>2009</risdate><volume>200</volume><issue>3</issue><spage>281.e1</spage><epage>281.e5</epage><pages>281.e1-281.e5</pages><issn>0002-9378</issn><eissn>1097-6868</eissn><coden>AJOGAH</coden><abstract>Objective Our objective was to evaluate the effect of thromboprophylaxis on pregnancy outcomes in asymptomatic women with inherited thrombophilias. Study Design This was a retrospective cohort study of asymptomatic pregnant women with inherited thrombophilias. Medical records were reviewed for pregnancy events, diagnosis of thrombophilias, and management in subsequent pregnancies. Outcomes in women who were and were not treated with thromboprophylaxis were compared using Fisher's exact test and logistic regression. Results Fifty-three women had 75 pregnancies subsequent to their diagnosis of thrombophilia. Women treated with heparin had similar rates of live births (86% vs 82%; P = .8, Fisher's exact test) as those not treated. The odds ratio of live birth in all pregnancies for women treated with heparin was compared with untreated women and was 1.9 (95% confidence interval, 0.5-6.3). Conclusion Pregnancy outcomes are often good in asymptomatic women with thrombophilias in the absence of treatment. Treatment of these women during pregnancy should be considered investigational.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>19114274</pmid><doi>10.1016/j.ajog.2008.10.021</doi><tpages>2</tpages></addata></record> |
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| subjects | Adult Anticoagulants - therapeutic use Biological and medical sciences Cohort Studies Female Gynecology. Andrology. Obstetrics Hematologic and hematopoietic diseases Heparin - therapeutic use Humans Logistic Models Medical sciences Obstetrics and Gynecology Platelet diseases and coagulopathies Pregnancy Pregnancy Complications - diagnosis Pregnancy Complications - prevention & control Pregnancy Outcome pregnancy outcomes Retrospective Studies thrombophilia Thrombophilia - diagnosis Thrombophilia - drug therapy thromboprophylaxis Treatment Outcome Young Adult |
| title | Thromboprophylaxis and pregnancy outcomes in asymptomatic women with inherited thrombophilias |
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