Expectant Management Outperforms LMWH in Umbilical Artery Thrombosis, Study Finds

China: A recent study published in Frontiers in Medicine has cast doubt on the therapeutic value of low-molecular-weight heparin (LMWH) in managing umbilical artery thrombosis (UAT) during pregnancy, suggesting that expectant management may be more beneficial in improving maternal and fetal outcomes.
Umbilical artery thrombosis is a rare but potentially life-threatening pregnancy complication caused by clot formation that obstructs blood flow through the umbilical artery. This can severely limit the fetus's oxygen and nutrient supply, increasing the risk of fetal distress, growth restriction, or stillbirth. Due to its rarity, there is no clear consensus on standardized treatment. Diagnosis usually involves a Doppler ultrasound and pathological confirmation, and management aims to prolong gestation and improve outcomes. While LMWH is sometimes used, its benefits over expectant management remain unclear.
Against the above background, Peng Zhao, Department of Obstetrics, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China, and colleagues conducted the study to evaluate the therapeutic value of LMWH in managing UAT during pregnancy.
For this purpose, the researchers conducted a retrospective study spanning from January 2013 to December 2023 involving singleton pregnant women diagnosed with umbilical artery thrombosis. The participants were divided into two groups: the experimental group received low-molecular-weight heparin as part of anticoagulation therapy during pregnancy, while the expectant group received standard prenatal care without targeted intervention for UAT.
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