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Phlebologie 2015; 44(01): 7-13
DOI: 10.12687/phleb2233-1-2015
Original article
Schattauer GmbH

Treatment of high risk pregnancies

Artikel in mehreren Sprachen: English | deutsch
H Kiesewetter
1   MVZ Hämostaseologicum; Berlin/Germany
,
R Becker
2   Private practice in Berlin, Germany
,
M Breitkopf
2   Private practice in Berlin, Germany
,
S Baumgarten
2   Private practice in Berlin, Germany
,
G Halis
2   Private practice in Berlin, Germany
,
A Höhne
2   Private practice in Berlin, Germany
,
A Jantke
2   Private practice in Berlin, Germany
,
C Kießling-Rau
2   Private practice in Berlin, Germany
,
K Kuhlmann
2   Private practice in Berlin, Germany
,
S Kunert
2   Private practice in Berlin, Germany
,
M Entezami
2   Private practice in Berlin, Germany
,
DJ Peet
2   Private practice in Berlin, Germany
,
M Reißig
2   Private practice in Berlin, Germany
,
B Ristau
2   Private practice in Berlin, Germany
,
FP Schmidt
2   Private practice in Berlin, Germany
,
P Sydow
2   Private practice in Berlin, Germany
,
P Tabor-Wessel
2   Private practice in Berlin, Germany
,
E Yüksel
2   Private practice in Berlin, Germany
,
R Duncker
4   Private practice in Trebbin, Germany
,
R Münchow
5   Private practice in Werder, Germany
,
A Röding
6   Private practice in Nauen, Germany
,
S Clausnitzer
3   Private practice in Potsdam, Germany
,
FH Giers
3   Private practice in Potsdam, Germany
,
M Hubatsch
3   Private practice in Potsdam, Germany
,
S Maas
3   Private practice in Potsdam, Germany
,
K-T Moeller
3   Private practice in Potsdam, Germany
,
A Stellmacher
3   Private practice in Potsdam, Germany
,
M Zöllner
3   Private practice in Potsdam, Germany
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Publikationsverlauf

Received: 03. September 2014

Accepted after major revision: 10. Dezember 2014

Publikationsdatum:
04. Januar 2018 (online)

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Summary

Introduction: The efficacy of a therapy with certoparin; also in combination with aspirin and prednisolone; in high-risk pregnancies has been examined prospectively.

Method: Data of 616 pregnancies have been analyzed. 238 patients injected Mono Embolex 3000; 239 patients Mono Embolex 8000 only. 62 patients injected Mono Embolex 8000 and took aspirin 50–100 mg daily; 60 Mono Embolex 3000 and aspirin 50–100 mg daily. 30 patients took aspirin 50–100 mg; prednisolone 2.5–5 mg and 17 injected mono Embolex 8000; 13 Mono Embolex 3000 daily from the start of their pregnancy. The target variable was the life birth rate.

When given aspirin the HPA-status of the partner is measured if the pregnant woman is negative for HPA 1a or 5b. In HPA-negative mothers and HPA-positive fathers a test for HPA-antibodies is performed posterior week 16.

Result: Applied early; a mean life birth rate of 95 % has been achieved in the monotherapy with Mono Embolex. Where heparin and aspirin were applied before pregnancy week 17 a life birth rate of 100 % was achieved. In patientswith a combination of aspirin and prednisolone a life birth rate of 87 % was achieved. Considering the life birth rate the status of thrombophilia gene-polymorphisms is irrelevant. The HPA-status was examined in 139 patients. In one of the HPA 5a-negative and 3 of the HPA 5b-negative women an immunization occurred but the platelet count of the fetus was not decreased. 3.3 % showed local allergic reaction and 0.5 % slight bleeding.

Conclusion: Certoparin, aspirin and prednisolone are safe drugs to increase life birth rate.

Keywords

Risk pregnancies - heparin - aspirin - predniso-lone - life birth rate