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Treatment for Pregnancy Complications Ineffective

An anti-blood clotting treatment for a range of serious pregnancy complications is ineffective, costly and painful for pregnant women, according to research published in The Lancet.

Complications that have been linked to thrombosis in pregnant women include clotting of the placenta, pre-eclampsia, low birth weight babies, recurrent miscarriage and stillbirth.

Pregnancy carries its own increased risk of thrombosis, but some women have an increased tendency, either because of a genetic predisposition or because of some other acquired factor.

Since these links were discovered in the 1990s, an anticoagulant called low molecular weight heparin has been used in an attempt to prevent the complications in high-risk pregnant women.

However, the results of the 10-year study of 292 high-risk pregnant women with a clotting tendency were “convincingly negative”.

“For many years the use of low molecular weight heparin to treat such women has been widely accepted, despite limited research into its effectiveness,” says co-author Prof Bill Hague of the University of Adelaide’s Robinson Research Institute. “The treatment is expensive and has to be given by daily, or twice daily, painful injections. Nevertheless, there has been a strong view among many clinicians that such treatment is justified on theoretical grounds in order to prevent significant complications of pregnancy.”

Hague says the study shows that there was no real difference in pregnancy outcome for those women who received the treatment compared with those who did not, with a small increase in minor bleeding complications among the women who were treated. “We found that the treatment did not reduce the incidence of the primary complications, such as severe or early onset pre-eclampsia, low birth weight, pregnancy loss or vein blood clots,” he says.