Impact of heparin and antiplatelet agents on pregnancy outcome in women with chronic renal failure

The pregnancy has more likely a poorer outcome in patients with chronic kidney disease (CKD) than in general population due to the increased frequency of serious complications including preeclampsia (PE) and placental insufficiency. Objectives: The study was undertaken to assess the effectiveness of heparin and antiplatelet therapy for prevention of complications and improvement pregnancy outcomes in women with chronic renal failure (CRF). Design and methods: the study included 15 women with CKD who already has got a wanted pregnancy during which they have not been treated with heparin and/or antiplatelet agents. At the beginning of a new pregnancy all patients had already CKD stage 3 (median GFR 49 mL/min) and were treated since the early stages of pregnancy with heparin and dipyridamole for the prevention of PE and placental insufficiency. The study group consisted of 16 pregnancies with the use of heparin and antiplatelet agents; the control group was 21 anamnestic pregnancies of the same women without receiving anticoagulants or antiplatelet agents. Results: in the study group the frequency of favorable outcomes of pregnancies was significantly higher than in the control group: 15 out of 16 (93.7%) versus 9 out of 21 (42.9%), p=0.002. None of the patients needed a permanent renal replacement therapy during 12 months after delivery. Conclusions: in women with CKD stage 3 heparin and dipyridamole helped to improve pregnancy outcomes: live birth and survival in the postnatal period without significant deterioration in renal function in mothers during the year.

беременность, исходы, антикоагулянты, гепарин, антиагреганты, хроническая болезнь почек, хроническая почечная недостаточность, pregnancy, outcomes, anticoagulants, heparin, antiplatelet agents, chronic kidney disease, chronic renal failure

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