[Dr.Vad]

Результаты недавнего мета-анализа указывают, что назначение НМГ может быть эффективным средством предупреждения осложений беременности, связанных с плацентой (преэклампсия, невынашивание на сроке более 20 недель, преждевременные роды, низкий вес при рождении):

Blood. 2013 Dec 19. Meta-analysis of low molecular weight heparin to prevent recurrent placenta-mediated pregnancy complications.
Rodger MA, Carrier M, Le Gal G, Martinelli I, Perna A, Rey E, de Vries JI, Gris JC.
Hematology, University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada.
A 35 year old woman with recurrent severe placenta mediated pregnancy complications in her 2 pregnancies asks: Will low molecular weight heparin help prevent recurrent placenta mediated pregnancy complications in my next pregnancy? We performed a meta-analysis of randomised controlled trials (RCTs) comparing low molecular weight heparin (LMWH) versus no LMWH for the prevention of recurrent placenta-mediated pregnancy complications. We identified six RCTs, including a total of 848 pregnant women with prior placenta-mediated pregnancy complications. The primary outcome was a composite of PE, birth of a SGA newborn (<10th percentile), placental abruption, or pregnancy loss >20 weeks. Overall, 67/358 (18.7%) of women on prophylactic LMWH had recurrent severe placenta-mediated pregnancy complications, as compared with 127/296 (42.9%) women with no LMWH [relative risk reduction 0.52 (95% CI 0.32-0.86) (p=0.01) (I2 69% indicating moderate heterogeneity)]. We identified similar relative risk reductions with LMWH for individual outcomes including any PE, severe PE, SGA <10th, SGA <5th, preterm delivery <37 weeks and preterm delivery <34 weeks with minimal heterogeneity. Low molecular weight heparin may be a promising therapy for recurrent, especially severe, placenta mediated pregnancy complications but further research is required.