- Doubts emerge over heparin, which expectant mothers inject into stomach
- Scientists say it can cause unnecessary pain during pregnancy
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Daily injections for pregnant women at risk of developing blood clots don’t work, and could be harmful, warn researchers.
Treatment does not have any positive benefits for mother or child, and may cause problems by increasing bleeding in the mother.
Findings from a major new trial could lead to less use of the anti-clotting drug heparin, which involves a woman injecting herself in the belly during pregnancy.
Although the practice is widespread, a large study has never before demonstrated whether it actually works.
Findings from a major new trial could lead to less use of the anti-clotting drug heparin, which involves a woman injecting herself in the belly during pregnancy. File picture
Professor Marc Rodger, a senior scientist at the Ottawa Hospital Research Institute, Canada, who led the study, said ‘These results mean that many women around the world can save themselves a lot of unnecessary pain during pregnancy.
‘Using low molecular weight heparin (LMWH) unnecessarily medicalises a woman’s pregnancy and is costly.’Â
“While I wish we could have shown that LMWH prevents complications, we actually proved it doesn’t help.’
Up to one in 10 pregnant women has a tendency to develop blood clots in their veins, a condition called thrombophilia. File picture
Up to one in 10 pregnant women has a tendency to develop blood clots in their veins, a condition called thrombophilia.
Prof Rodger’s clinical trial, which involved 292 women with thrombophilia in 36 centres in five countries, is published online in The Lancet medical journal (must credit).
It took 12 years to complete because half the women taking part had to be given no treatment – and the majority of women with thrombophilia are automatically treated with LMWH.
Altogether 143 women taking part were assigned to daily injections up to 20 weeks’ pregnancy, and twice daily until 37 weeks of pregnancy, while 141 women had no treatment (three women were not able to take part).
Regular drug treatment did not reduce the risk of major complications including loss of the baby and blood clots.
The occurrence of major bleeding did not differ between the two groups.
But minor bleeding was more common in the group assigned to injections.
This could cause pregnant women some minor harm because bleeding increases their rates of induced labour and may mean they cannot have anaesthesia during childbirth.
The study concluded there is still one type of thrombophilia known as anti-phospholipid antibodies for which blood thinners may be effective in preventing recurrent miscarriage.
Some women are advised to take low-dose aspirin while pregnant to help prevent pregnancy complications – was not the subject of the trial – and all women with thrombophilia need blood thinners to prevent blood clots after delivery.
Prof Rodger said ‘These findings allow us to move on, to pursue other, potentially effective, methods for treating pregnant women with thrombophilia and/or complications from placenta blood clots.’
Dr Duncan Stewart, chief executive officer and scientific director of the Ottawa Hospital Research Institute, said ‘Dr Rodger’s findings will benefit many women in many countries who will be spared from hundreds of unnecessary and painful injections.
‘They also underscore the importance of conducting rigorous, well-designed clinical trials.’
There was no comment available from the Royal College of Obstetricians and Gynaccologists.
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