Antithrombotic therapy for improving maternal or infant health outcomes in women considered at risk of placental dysfunction

Pregnancy complications such as pre-eclampsia and eclampsia, intrauterine fetal growth restriction and placental abruption are thought to be related to abnormalities in the development and function of the placenta. Treatment with heparin to prevent the development of blood clots within the placenta appears promising to prevent these complications. The number of pregnant women with pre-eclampsia, eclampsia, and infant birthweight less than the 10th centile for gestational age (a measure of low infant birth weight) was reduced. Five studies involving 484 women met the inclusion criteria for the review. Four studies compared heparin (alone or in combination with dipyridamole) with no treatment; and one compared triazolopyrimidine with placebo. For the majority of outcomes, the number of included studies and participants was small. The most commonly recognised minor side effect for women related to this treatment was skin bruising. To date important information about serious adverse infant and long-term childhood outcomes with using anti-clotting medications is unavailable. Further research is required.