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Does low molecular weight heparin shorten term labor?
Gunvor Ekman-Ordeberg1, Anna Akerud, Aurelija Dubicke
1Department of Women and Child Health, Division of Obstetrics and Gynecology, Karolinska Institutet, Stockholm, Sweden. gunvor.ekman-ordeberg@ki.se
Acta Obstetricia Et Gynecologica Scandinavica
|October 17, 2009
Summary
Dalteparin, a low molecular weight heparin (LMWH), significantly shortened labor time by 30% in pregnant women with thrombotic disorders. This treatment also reduced operative interventions for protracted labor without affecting neonatal outcomes.
Area of Science:
- Obstetrics and Gynecology
- Pharmacology
- Thrombosis Research
Background:
- Low molecular weight heparin (LMWH) use in pregnancy for thrombotic disorders is established.
- Changes in heparan sulfate proteoglycans during labor suggest a potential role for LMWH in parturition.
- Clinical observations indicated LMWH might shorten delivery duration.
Purpose of the Study:
- To investigate the effect of dalteparin on labor duration in nulliparous women with thrombotic conditions.
- To compare labor times between dalteparin-treated pregnant women and matched untreated controls.
- To assess the impact of dalteparin on instrumental delivery rates and neonatal outcomes.
Main Methods:
- Retrospective analysis of labor times in nulliparous women treated with dalteparin for venous thromboembolism (VTE) or thrombophilia.
- Matching of dalteparin-treated patients with untreated controls.
- Comparison of total instrumental deliveries, operative interventions for protracted labor, and neonatal outcomes between groups.
Main Results:
- Dalteparin-treated women experienced a significant 30% reduction in labor time compared to controls.
- No significant difference was observed in the overall proportion of instrumental deliveries.
- Operative interventions specifically due to protracted labor were significantly less frequent in the dalteparin group.
Conclusions:
- Dalteparin administration is associated with a shortened parturition time in pregnant women with thrombotic disorders.
- Dalteparin may reduce the necessity for operative interventions related to prolonged labor.
- Neonatal outcomes remain unaffected by dalteparin treatment in this cohort.
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