A Meta-analysis Of The Efficacy And Safety Of Low Molecular Weight Heparin In The Treatment Of Early-onset Severe Preeclampsia

Objective:To evaluate the efficacy and safety of low molecular weight heparin in early onset severe preeclampsia.Methods:Search through PubMed,Cochrane Libary,China Knowledge Network(CNKI),Wanfang database and Weipu Chinese journal database to search for relevant literature published at home and abroad on low-molecular-weight heparin treatment of early-onset severe preeclampsia.Until January 2020,Meta analysis of the research data was carried out using RevMan 5.3 software.Results:A total of 37 literatures were included in this meta-analysis.The meta-analysis results showed that the addition of LMWH could reduce the average arterial pressure of patients with early onset severe preeclampsia [WMD=-9.56,95%ci(-11.54,-7.58),P < 0.00001].Decreased urinary protein [SMD=-1.23,95%CI(-1.67,-0.79),P <0.00001];Reduce red blood cells deposited,fibrinogen and D-dimer [WMD = 0.69,95% CI(1.29,0.08),P = 0.03] [WMD = 1.37,95% CI(1.91,0.84),P < 0.00001][SMD = 1.44,95% CI(2.09,0.78),P < 0.0001];There was no significant difference in prothrombin time,activated partial thrombin time and platelet count.There were statistically significant differences in improving blood lipid-related indexes.Prolongation of gestational weeks [WMD=4.91,95%ci(4.37,5.46),P < 0.00001];Increase of newborn birth weight [SMD=0.85,95%ci(0.38,1.32),P=0.0004];Reduce fetal umbilical cord blood flow S/D value(MD = 0.45,95% CI(0-0.62,0.28),P <0.00001];Reduced neonatal asphyxia rate [RR=0.46,95%ci(0.36,0.58),P < 0.00001].Decreased perinatal mortality [RR=0.35,95%ci(0.23,0.54),P < 0.00001].The incidence of postpartum hemorrhage was reduced [RR=0.53,95%ci(0.36,0.77),P=0.0009].Reduce the incidence of placental abruption [RR=0.30,95%CI(0.16,0.56),P=0.0001] et al.Conclusion:The clinical efficacy of low molecular weight heparin(LMWH)in early onset severe preeclampsia is safe and feasible.