Management and Outcome of Heparin-Induced Thrombocytopenia in Pregnancy: A Systematic Review
Systematic review published in Cardiovascular & hematological agents in medicinal chemistry (2015)
Abstract
OBJECTIVE: Safety and efficacy of therapeutic agents used for heparin-induced thrombocytopenia are not established in pregnancy. METHODS: MEDLINE database was searched in November 2014 to identify all patients who received therapy for HIT during pregnancy. RESULTS: A total of 12 patients with the median age of 28 years (range 21-39) were diagnosed with HIT at the median gestational age of 20 weeks (range 5-34). Clinical probability (4T) score for HIT was high (50%) or intermediate (50%) and associated with thrombosis in 50%. Patients were initially managed with lepirudin (33%), argatroban (25%), danaparoid (25%) or fondaparinux (17%) and ultimately bridged to vitamin K antagonist or maintained on lepirudin. All patients had resolution of HIT. Complications included therapeutic abortion prior to valve replacement for valve thrombosis (8%), preterm delivery (18%) and preeclampsia (8%). Except for one instance of hypoplastic lung related to preterm delivery, none of the other newborns had any complications during delivery. CONCLUSION: Confirmed cases of HIT in pregnant patients appear to be rare. Within the limits of retrospective analysis, the use of argatroban, danaparoid, fondaparinux and lepirudin may be effective in preventing the thrombotic complications of HIT in pregnancy. The effect of HIT or its therapy on obstetrical complications cannot be determined based on this study since many of the obstetrical complications are common in otherwise healthy pregnancies. Although this study did not identify any fetal teratogenicity except hypoplastic lung related to preterm delivery, small number of cases treated with various therapies precludes any definite conclusion.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Резюме
Management and Outcome of Heparin-Induced Thrombocytopenia in Pregnancy: A Systematic Review.
Почему это важно для гирудотерапии
В данном исследовании был выполнен поиск в MEDLINE для выявления всех описанных пациентов, получавших лечение гепарин-индуцированной тромбоцитопении (HIT) во время беременности; было выявлено 12 случаев, леченных лепирудином (33%), аргатробаном, данапароидом или фондапаринуксом. У всех пациентов достигнута резолюция HIT, хотя в числе осложнений наблюдались преждевременные роды, преэклампсия и один терапевтический аборт. В резюме лепирудин указан только по названию, без описания его происхождения или механизма действия и без упоминания пиявок, гирудина или гирудотерапии, поэтому обоснованная связь с областью компетенции ASH в данной статье не установлена. Кроме того, крайне малое число выявленных случаев, леченных различными методами, не позволяет сделать каких-либо определённых выводов относительно безопасности или акушерских исходов.
Цитирование
Management and Outcome of Heparin-Induced Thrombocytopenia in Pregnancy: A Systematic Review
Chaudhary RK et al. · Cardiovascular & hematological agents in medicinal chemistry, 2015
Связанный клинический контекст
Узнайте, как это исследование связано с клинической практикой
Добавлено в библиотеку ASH: May 27, 2026 · Последнее обновление сайта: 18 июня 2026 г.