An animal model has implicated elevated levels of tissue factor (TF), and resultant hypercoagulability and inflammation, as key factors in recurrent pregnancy loss (RPL) and has demonstrated that pravastatin is effective in treating this condition. In this study, we have re-evaluated the contraindication of statins during pregnancy. Evaluation has shown that while animal testing (at maternally toxic doses) and case reports of birth defects have led to the contraindication of statins during pregnancy, our controlled study, similar to previously published controlled studies, has failed to demonstrate increased fetal risks. As well, we demonstrated that transfer of pravastatin across the placenta is likely limited. While short term suspension of therapy during gestation is considered safe, extended time without therapy is detrimental to cardiovascular health. Coupled with a trend of elevated TF levels in women with RPL, reconsideration of the contraindication of statins is warranted based on appropriate risk: benefit assessment.
| Identifer | oai:union.ndltd.org:TORONTO/oai:tspace.library.utoronto.ca:1807/33625 |
| Date | 27 November 2012 |
| Creators | Zarek, Judith |
| Contributors | Koren, Gideon |
| Source Sets | University of Toronto |
| Language | en_ca |
| Detected Language | English |
| Type | Thesis |
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