Heparin for patients with growth restricted fetus: A prospective randomized controlled trial

Abstract

Objective. Heparin was hypothesized to facilitate the growth of the growth-restricted fetus. Our study was to assess the efficiency of heparin in treating fetus with growth restriction and to explore the possible mechanisms.

Methods. Seventy-three pregnant women were selected in this study. Based on regular treatments, patients randomly received either heparin or dan-shen combined with low-molecular weight dextrose. A serial ultrasonography and hematological measurements were performed on each patient at the enrolment and 7 days after the first treatment. Neonatal birth weight, 1-min Apgar score and gestational age were recorded. Placentas were collected for apoptotic indices.

Results. Heparin significantly improved maternal hemorrheological indices, fetal growth velocities and neonatal outcomes. It also reduced apoptosis in trophoblasts.

Conclusions. Our results provide evidence that heparin significantly improves the growth of the growth-restricted fetus. The growth improvement is probably achieved by the changes in maternal hemorrheology and the attenuated apoptosis in trophoblasts.

Keywords:

• Apoptosis
• fetal growth restriction
• hemorrheology
• heparin
• ultrasonography

Acknowledgements

We are grateful for the technical assistance of Jin-Hua Zhang and Xiao-Rong Liu. We also thank Prof. Gary Lu (Department of Hematopathology, UT-MD Anderson Cancer Center, Houston, TX) for his critical review of the manuscript.

This work was supported by the Grant of Key Project in Multidisciplinary Research on the Top Focus Social Problems of Guangdong Province. 2KB04701S.