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Fractionated and Unfractionated Heparin During Pregnancy

الهبارين المجزأ و غير المجزأ و الحمل

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 Publication date 2004
and research's language is العربية
 Created by Shamra Editor




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Clinicians are occasionally faced with the dilemma of managing pregnant patients who require ongoing anticoagulation. Examples include women with mechanical heart valves, venous thromboembolism, and chronic atrial fibrillation. Methods : A prospective study randomly assigned 33 pregnant women aged between 22 and 43 years (average; 28.4); to receive either fractionated heparin: Enoxaparin (The 1st group, n = 17) or unfractionated heparin (The second group, n=16). In both groups, patients were given heparin (fractionated or unfractionated) during the 1st trimester and last month of pregnancy, and took warfarin between the 4th and 8th month.


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Research summary
تتناول هذه الدراسة استخدام الهيبارين المجزأ وغير المجزأ أثناء الحمل. يواجه الأطباء أحيانًا معضلة إدارة المرضى الحوامل الذين يحتاجون إلى مضادات التخثر المستمرة، مثل النساء اللواتي لديهن صمامات قلب ميكانيكية أو انسداد وريدي أو رجفان أذيني مزمن. أجريت الدراسة على 33 امرأة حامل تتراوح أعمارهن بين 22 و43 عامًا، وتم تقسيمهن عشوائيًا إلى مجموعتين: المجموعة الأولى تلقت الهيبارين المجزأ (Enoxaparin) والمجموعة الثانية تلقت الهيبارين غير المجزأ. تم إعطاء الهيبارين في الثلث الأول والشهر الأخير من الحمل، بينما تم استخدام الوارفارين بين الشهر الرابع والثامن. أظهرت النتائج عدم وجود مضاعفات نزيفية أو تخثرية في مجموعة Enoxaparin، بينما ظهرت مضاعفات في مجموعة الهيبارين غير المجزأ بنسبة 12.5% للنزيف و5.5% للتخثر. خلصت الدراسة إلى أن استخدام الهيبارين المجزأ آمن أثناء الحمل ولا يسبب مضاعفات.
Critical review
دراسة نقدية: تعتبر هذه الدراسة مهمة لأنها تساهم في توضيح أمان استخدام الهيبارين المجزأ أثناء الحمل. ومع ذلك، هناك بعض النقاط التي يمكن تحسينها. أولاً، حجم العينة صغير نسبياً، مما قد يؤثر على تعميم النتائج. ثانياً، لم يتم تناول التأثيرات الطويلة الأمد لاستخدام الهيبارين المجزأ على الأمهات والأطفال. ثالثاً، كان من الممكن أن تكون الدراسة أكثر شمولية إذا تضمنت مقارنة بين أنواع أخرى من مضادات التخثر. على الرغم من هذه النقاط، فإن الدراسة تقدم مساهمة قيمة في مجال طب الحمل ومضادات التخثر.
Questions related to the research
  1. ما هو الهدف الرئيسي من الدراسة؟

    الهدف الرئيسي من الدراسة هو تقييم أمان استخدام الهيبارين المجزأ وغير المجزأ أثناء الحمل.

  2. ما هي الأعمار التي شملتها الدراسة؟

    شملت الدراسة نساء حوامل تتراوح أعمارهن بين 22 و43 عامًا.

  3. ما هي النتائج الرئيسية للدراسة؟

    النتائج الرئيسية أظهرت عدم وجود مضاعفات نزيفية أو تخثرية في مجموعة Enoxaparin، بينما ظهرت مضاعفات في مجموعة الهيبارين غير المجزأ بنسبة 12.5% للنزيف و5.5% للتخثر.

  4. ما هي التوصيات النهائية للدراسة؟

    توصي الدراسة باستخدام الهيبارين المجزأ كخيار آمن لمضادات التخثر أثناء الحمل.


References used
Salzman, EW low molecular-Weight heparin: is small beautiful? N Engl. J Med 1986, 315:957
Green D, hirsh J, Heit J et al .low molecular-weight heparin: a critical analysis of clinical trials. pharmacol Rev 1994,46:89
Weitz, JI .low molecular-Weight heparins: N Engl. J Med 1997 ,337:688
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