Low-molecular-weight heparin and aspirin in the prevention of recurrent early-onset pre-eclampsia in women with antiphospholipid antibodies: the FRUIT-RCT

European Journal of Obstetrics, Gynecology, and Reproductive Biology
M E Van HoornFRUIT Investigators

Abstract

To examine whether combined treatment with low-molecular-weight heparin (LMWH) and aspirin reduces recurrent hypertensive disorders of pregnancy (HD: pre-eclampsia, eclampsia or HELLP syndrome) in women with antiphospholipid antibodies (aPLA) and a previous delivery for HD and/or small-for-gestational-age (SGA) birthweight before 34 weeks gestation. This multicentre randomised controlled trial was performed between December 2000 and December 2009. Women were recruited from all eight university and six non-university/teaching hospitals in The Netherlands, two university hospitals in Australia and one university hospital in Sweden. Thirty two women with a previous delivery <34 weeks gestation with HD and/or SGA and aPLA were included before 12 weeks gestation. The intervention was daily LMWH with aspirin or aspirin alone. recurrent HD onset <34 weeks and recurrent HD irrespective of gestational age. Analysis by intention-to-treat. After an interim analysis, recruitment was ceased: accrual was low and the incidence of recurrent HD was far lower (3%) than expected (60%). The final analysis, performed on 32 women, shows no difference in the primary outcomes (LMWH and aspirin 0/16 versus aspirin only 1/16, risk difference 6.25% [CI -...Continue Reading

References

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Citations

Sep 7, 2016·Hypertension in Pregnancy : Official Journal of the International Society for the Study of Hypertension in Pregnancy·Carolien N H AbheidenJohanna I P de Vries
May 10, 2017·Autoimmunity Reviews·Arsène MekinianUNKNOWN on the behalf of the SNFMI and the European Forum on Antiphospholipid Antibodies
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Mar 7, 2019·Blood Advances·Johanna GebhartIngrid Pabinger
Jan 23, 2018·Frontiers in Medicine·Louise C Kenny, Douglas B Kell
Sep 4, 2019·Thrombosis Research·Karen Schreiber, Beverley J Hunt
Nov 11, 2020·Journal of Gynecology Obstetrics and Human Reproduction·Paul GuerbyEmmanuel Bujold
Sep 16, 2017·Current Opinion in Obstetrics & Gynecology·Karen SchreiberSavino Sciascia
Jan 27, 2021·Journal of Korean Medical Science·Eunyoung Emily LeeEun Bong Lee
Jan 11, 2021·Clinical Pharmacology and Therapeutics·Alessandra BettiolAlfredo Vannacci
Mar 5, 2020·Taiwanese Journal of Obstetrics & Gynecology·Fatemeh Alsadat RahnemaeiMahmoud Abbasi
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Antiphospholipid Syndrome

Antiphospholipid syndrome or antiphospholipid antibody syndrome (APS or APLS), is an autoimmune, hypercoagulable state caused by the presence of antibodies directed against phospholipids.