Resistencia a la proteína C activada y gestación. Uso de heparina de bajo peso molecular

SUMMARY We study the possibilities of using low molecular weight heparin (enoxaparine) in patients with activated C protein, associated to a mutation of Factor V Leiden, which is the most frequently found constitutional haemostatic anomaly in Europe. A prospective study of 7 pregnant women, heterozygote (3 patients) or homozygote (4 patients) for Factor V Leiden mutation. They all had familial or personal history of severe thrombotic disease and received 40 mg of enoxaparine daily. There were no thrombosis or haemorrhages recorded during pregnancies or deliveries. All the infants did well. After birth, low molecular weight heparin was continued for 8-12 weeks, depending on allelic status and history. We reviewed the literature on this subject. This prospective study seems to confirm the efficacy of low molecular weight, for its excellent maternal and foetal tolerance and is at least comparable to standard heparins.