Can Low Molecular Weight Heparin During Pregnancy With Intrauterine Growth Restriction Increase Birth Weight? (IUGR)

University of Aarhus

Status and phase: Completed; Phase 4

Conditions: Fetal Growth Retardation

Treatments: Drug: Innohep (Tinzaparin); Drug: tinzaparin

Study type: Interventional

Funder types: Other; Industry

Identifiers

NCT01390051

M-20110042

Details and patient eligibility

About

The purpose of the study is to investigate if treatment with an anticoagulant drug increases birth weight in pregnancies complicated by fetal growth restriction.

Full description

Clinical purpose:

1. To examine whether treatment with low molecular weight heparin in pregnant women with Intrauterine Growth Restriction (IUGR)increases the birth weight of the child. Our hypothesis is that an increased birth weight leads to reduced morbidity and mortality among these children.

Laboratory purposes:

1. To evaluate three new methods to monitor the effect of LMWH.
2. To investigate if 2 biochemical markers are positive predictors of IUGR IUGR is defined as a foetus that grows less than expected. IUGR is estimated to occur in up to 5% of all pregnancies, and IUGR is the second most common cause of perinatal morbidity and mortality. Thus, 75% of all stillbirths are caused by IUGR. IUGR is diagnosed by ultrasonography. In IUGR the uteroplacental blood flow is often compromised resulting in foetal growth restriction.

Design: The study is a prospective randomised study where pregnant women with suspected severe IUGR are randomised either to treatment with Innohep® or no treatment. Half of the women receive Innohep® and half of the women do not receive treatment.

Endpoints The primary endpoint is the difference in birth weight in children born of women receiving Innohep® during pregnancy and children born of women who have not received Innohep® during pregnancy

Enrollment: 50 patients

Sex: Female

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Singleton pregnancy
2. IUGR shown by ultrasonography:
3. Can understand and read Danish

Exclusion criteria

1. Age below 18 years
2. Pregestational weight < 90 kilograms
3. Not able to give informed consent
4. Chronic kidney disease with creatinine >150 μmol/l
5. Chronic hypertension with blood pressure >140/90 mmHg
6. Diabetes mellitus; type 1 or 2 or gestational diabetes
7. Inflammatory bowel disease
8. Severe heart disease (including mechanical heart valves)
9. Drug or alcohol abuse
10. Known coagulopathy (von Willebrand disease, thrombocytopenia, carrier of haemophilia)
11. Treatment with vitamin K antagonists
12. Known allergy to low LMWH
13. Previous heparin-induced thrombocytopenia (HIT (type II))
14. Clinically significant bleeding within the last month
15. Women with indication for prophylactic treatment with LMWH during pregnancy e.g. previous thromboembolic disease or serious types of thrombophilia (deficiency of antithrombin, protein C or protein S)
16. Chromosome anomaly in the child
17. Severe malformations in the child
18. Contraindication to Innohep®
19. Gestational week > 32 weeks

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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50 participants in 2 patient groups

Innohep

Active Comparator group

Description:

Tinzaparin 4500 I.U. sub cutaneous once daily until gestational week 37

Treatment:

Drug: tinzaparin

Drug: Innohep (Tinzaparin)

no treatment

No Intervention group