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Treating thrombophilia in pregnancy

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Editor ● 2 min read


Low-molecular weight heparin (LMWH), a blood thinner administered by daily injection, is currently the conventional treatment of choice for the management of thrombophilia – a condition that increases the risk of pregnancy loss and complications such as placental blood clots. However, researchers who set out to test its effectiveness found it no better than no treatment at all, albeit at higher financial cost and unnecessary pain inflicted on the patient.[1]

The 12-year study followed 292 pregnant women with thrombophilia in five countries. Of these women, 146 received blood thinner injections until at least 37 weeks of gestation; 143 study participants did not receive the blood thinner. Three women were excluded. In the cohort receiving the treatment, 25 out of 146 women experienced complications from thrombophilia. In the non-treatment group, 27 out of 143 had complications.

“These results mean that many women around the world can save themselves a lot of unnecessary pain during pregnancy,” Dr Marc Roger, senior scientist at the Ottawa Hospital Research Institute, said in a press statement.

“These findings allow us to move on, to pursue other potentially effective methods for treating pregnant women with thrombophilia and/or complications from placenta blood clots.”

Are there natural options for clotting?

In an early experimental study, researchers demonstrated that while heparin significantly reduced the number of emboli following an arterial injury, it did not improve capillary perfusion. In contrast, cod liver oil did not reduce the number of emboli, but led to a significantly improved capillary perfusion. These findings suggest that the harmful effects that platelet emboli have on microcirculation are likely to be – at least in part – biochemical in nature (i.e. vasoconstriction) rather than simply related to a mechanical obstruction of flow.[2]

Omega-3 fatty acids (from fish oil) have anti-inflammatory and antithrombotic effects. By competing with arachidonic acid in the cyclooxygenase and lipoxygenase pathways, omega-3 fatty acids decrease the synthesis of thromboxane A2, which is linked to platelet aggregation and vasoconstriction. Fish oil also increases the production of prostacyclin, a prostaglandin reduces platelet aggregation and causes vasodilation.[3]

While no studies have been undertaken on the efficacy of fish oil in the treatment of pregnancy complications such as thrombophilia, omega-3 fatty acids play a critical role prenatal and postnatal neurological development and are widely recommended for use in pregnancy and during lactation.

Garlic has also been shown to have antithrombotic effects.[4] It has been found to decrease platelet aggregation and adhesion, increase fibrinolytic activity and increase prothrombin time.

References

  1. Kinney S. Common treatment for pregnant women may be ineffective. dailyRx News 24 July 2014 [Link]
     
  2. Barker JH, Anderson GL, O’Shaughnessy M, et al. The effects of heparin and dietary fish oil on embolic events and the microcirculation downstream from a small-artery repair. Plast Reconstr Surg 1993;91(2):335-343. [Abstract]
     
  3. Fish oil. Natural Medicines Comprehensive Database 2014. [Link
     
  4. Garlic. Natural Medicines Comprehensive Database 2014. [Link

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