上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2020, Vol. 40 ›› Issue (3): 402-.doi: 10.3969/j.issn.1674-8115.2020.03.021

• 综述 • 上一篇    下一篇

复发性流产常用抗凝及抗血小板药物妊娠期暴露的安全性

孙 思，赵爱民   

  1. 上海交通大学医学院附属仁济医院妇产科，上海200120
  • 出版日期:2020-03-28 发布日期:2020-04-09
  • 作者简介:孙 思（1994—），女，博士生，电子信箱：sun_si_4@163.com。
  • 基金资助:
    国家自然科学基金（81671481）。

Safety of anticoagulants and antiplatelet drugs in patients with recurrent spontaneous abortion during pregnancy

SUN Si, ZHAO Ai-min   

  1. Department of Obstetrics and Gynecology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200120, China
  • Online:2020-03-28 Published:2020-04-09
  • Supported by:
    Natural National Science Foundation of China, 81671481.

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摘要： 复发性自然流产指连续发生2次及以上妊娠28周之前的胚胎或胎儿丢失，是危害女性生殖健康最常见的妊娠并发症之一。复发性流产病因复杂，主要包括染色体（基因）异常、女性生殖道解剖异常、内分泌因素、免疫学异常、血栓前状态、感染因素等多个方面。研究证实，针对血栓前状态及自身免疫异常导致的复发性流产患者，采用抗凝及抗血小板药物治疗能明显改善患者再次妊娠结局。目前临床上常用的抗凝药物包括肝素、肝素类似物、华法林等，常用的抗血小板药物有阿司匹林、氯吡格雷等。然而，妊娠期使用这些药物对母胎的安全性一直是人们关注的热点，该文就妊娠期暴露上述药物的母胎安全性研究进行综述。

关键词: 复发性流产, 抗凝剂, 抗血小板药物, 肝素, 肝素类似物, 华法林, 阿司匹林, 安全性

Abstract:

Recurrent spontaneous abortion (RSA) is defined as the loss of at least two consecutive pregnancies before the 28th week of gestation. RSA is a complicated pathological condition causedmultiple factors including genetic abnormalities, anatomical factors, endocrine disorders, immune abnormalities, prethrombotic state (PTS) and infection factors. Studies have suggested that anticoagulation and antiplatelet therapy could significantly improve the pregnancy outcomes of RSA patients with PTS and autoimmune abnormalities. Frequently used anticoagulants and antiplatelet drugs are heparin, heparinoid, warfarin, aspirin and clopidogrel. However, the maternal and fetal safety after the of these drugs during pregnancy has long been concerned. Safety of anticoagulants and antiplatelet drugs in patients with recurrent spontaneous abortion during pregnancy is reviewed.

Key words: recurrent spontaneous abortion, anticoagulants, antiplatelet drug, heparin, heparinoid, warfarin, aspirin, safety