Management of Pregnancies With a History of Venous Thromboembolism: Low-Dose Low-Molecular-Weight Heparin and Low-Dose Acetylsalicylic Acid Prophylaxis.

AIM: Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE) carries high risk of adverse maternal and fetal outcomes. This Study aimed to evaluate the effectiveness of low-dose low-molecular-weight heparin (LMWH) combined with low-dose acetylsalicylic acid (ASA) prophylaxis in women with a history of VTE.

METHODS

A total of 77 pregnant women with a history of VTE (42 DVT, 35 DVT + PE) received daily prophylaxis with low-dose LMWH (enoxaparin, 1 × 2000 anti-Xa IU/0.2 mL) and low-dose ASA (100 mg/day) upon confirmation of pregnancy. Gestational outcomes under prophylaxis were compared with their 256 previous pregnancies.

RESULTS

77.9% of the study cases were with maternal risk factors/comorbidities for thrombosis and obstetric complications. LMWH + ASA significantly reduced adverse gestational outcomes (71.9% vs. 46.8%, p < 0.001), including miscarriage (63.3% to 26%, p < 0.001) and preeclampsia (9%-1.3%, p = 0.022). No thrombotic events occurred.

CONCLUSIONS

Prophylactic use of low-dose LMWH and low-dose ASA is effective in the prevention of thrombotic events and improves gestational outcomes in women with a VTE history.