Related Experiment Video
Updated: May 22, 2025
Author Spotlight: Enhancing the Offspring Health in Rats with Maternal Exercise During Pregnancy
Published on: April 5, 2024
Chronic hypertension in pregnancy: insights into adverse outcomes prevention
Rossana Orabona1, Rossella Monaci2, Sara Branca2
1Department of Obstetrics and Gynecology, ASST-Spedali Civili of Brescia.
Insights
Low molecular weight heparin significantly reduces superimposed preeclampsia in pregnant women with chronic hypertension. This thromboprophylaxis is effective regardless of aspirin use, offering a targeted prevention strategy.
Area of Science:
- Obstetrics and Gynecology
- Cardiology
- Pharmacology
Background:
- Chronic hypertension in pregnancy is associated with increased risks of preeclampsia and fetal growth restriction.
- Identifying effective preventative strategies for these adverse outcomes is crucial for maternal and fetal well-being.
Purpose of the Study:
- To investigate the efficacy of low molecular weight heparin (LMWH) in preventing preeclampsia and/or fetal growth restriction in pregnant women with chronic hypertension.
- To assess the role of LMWH as thromboprophylaxis in this high-risk population.
Main Methods:
- Retrospective analysis of 219 pregnant women with chronic hypertension from January 2019 to January 2024.
- Primary endpoint: occurrence of preeclampsia and/or fetal growth restriction.
- Evaluation of prophylaxis including low-dose aspirin and LMWH, and assessment of uterine arteries Doppler velocimetry.
Main Results:
- Preeclampsia occurred in 22.9% and fetal growth restriction in 9.6% of patients.
- Low molecular weight heparin administration was associated with a significantly lower rate of preeclampsia (8.8% vs. 25%, P=0.04).
- High resistance in uterine arteries Doppler velocimetry was strongly linked to the onset of preeclampsia and fetal growth restriction.
Conclusions:
- Thromboprophylaxis with low molecular weight heparin effectively reduces the incidence of superimposed preeclampsia in pregnant women with chronic hypertension.
- The benefit of low molecular weight heparin in preventing preeclampsia is independent of concurrent aspirin therapy.
Objectives:
The aim of this study was to investigate the role of low molecular weight heparin in the prevention of preeclampsia and/or fetal growth restriction in pregnant women with chronic hypertension.
Methods:
Women diagnosed with chronic hypertension were retrospectively selected from our electronic database from January 2019 to January 2024. The primary endpoint was the occurrence of adverse pregnancy outcomes described as the onset of preeclampsia and/or fetal growth restriction.
Results:
A total of 219 pregnant women with chronic hypertension were included. BMI before pregnancy was 27.8 ± 6.4 kg/m 2 and age 36.1 ± 5.4 years. Preeclampsia and fetal growth restriction occurred in 22.9 and 9.6% of patients, respectively. As concerns prophylaxis in the first trimester, 80.1% of patients were administered low-dose aspirin (100 mg), while 16.7% low molecular weight heparin (at prophylactic doses according to BMI), of which 86.1% aspirin + heparin. The rate of preeclampsia was similar in patients taking aspirin or not (21.3 vs. 25%), while it significantly differed in those administered with heparin as thromboprophylaxis (8.8 vs. 25%, P = 0.04). Fetal growth restriction occurrence did not differ according to the use of prophylaxis. High resistance at uterine arteries Doppler velocimetry at 24-25 weeks of gestation was confirmed to be associated with the onset of preeclampsia (51 vs. 11.9%; P < 0.001) and fetal growth restriction (18.2 vs. 6.9%; P = 0.04).
Conclusion:
Thromboprophylaxis with low molecular weight heparin reduces the onset of superimposed preeclampsia, independently from aspirin intake.
Related Concept Videos
01:33Hormonal Regulation
01:18Hypertension and Regulation of Blood Pressure
01:25Errors occurring during blood pressure monitoring
Several factors...
01:28Factors affecting Blood pressure
Physiological Factors:
01:20Pathophysiology of Diabetes
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
01:30Alterations in Blood Pressure
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart...