protecting fetuses and their mothers - protecting fetuses and their mothers -

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Rambam researchers were the first in the world to link blood clotting with fetal loss and vascular complications in pregnant women. In light of these findings, they developed medical treatment that is now saving fetuses and their mothers around the globe

Writer: Roberta Neiger, ProText

Research at Rambam Health Care Campus (RHCC) has drawn a direct connection between blood clotting, and fetal loss and vascular complications in pregnant women. These findings led Rambam researchers to develop treatments now being performed on a large scale in hospitals throughout Israel and the rest of the world.

“We were among the first to demonstrate the contribution of blood clotting to gestational vascular complications like pre-eclampsia (hypertension in pregnancy), placental abruption (separation of the placental lining from the mother’s uterus), severe uterine growth restriction and uterine fetal death, and to intervene with therapy,” says Prof. Benjamin Brenner , Acting Director of the Department of Hematology and Bone Marrow Transplantation. Such complications occur in five to ten percent of pregnancies worldwide. “Since these complications can cause maternal and fetal mortality and premature births, this is a major public health issue,” he says.

In Israel, this issue is especially pressing, as roughly one in five Caucasian women here – some 15% of Jews and 25% of Arabs – have thrombophilia, an inherited tendency for clotting.

Taking their pioneering work one step further, researchers at the Rambam Institute of Hematology sought ways to prevent these devastating events. They initiated the first study on averting such complications with anti-clotting medications taken during pregnancy. “We generally give low-molecular weight Heparin, which reduces the re-occurrence of pregnancy complication by 75%,” says Prof. Brenner.

Women have special needs and problems associated with bleeding and clotting, explains Prof. Brenner. For example, bleeding disorders may manifest at menarche – the onset of menstruation while hormonal contraception and pregnancy increase the risk of thrombosis. Pregnancy, in particular, increases chances of clotting. “This phenomenon is rooted deep in the past, when women gave birth outside, in the fields,” explains Prof. Brenner. “Then, excessive bleeding was the most fearful complication. Over time, clotting became the body’s way of countering the bleeding.”

To this day, the clotting mechanism still plays an important role, as bleeding continues to pose a threat to pregnant women around the world. “In the developing world today, bleeding during childbirth is still a leading cause of death among women. In developed countries, women become pregnant at more advanced ages, which contribute to a higher risk of thrombosis.

In addition to his clinical and research activities, Prof. Brenner chaired, in early February, the fourth bi-annual conference on Women’s Issues in Thrombosis and Hemostasis, held in Berlin, Germany. This meeting, attended by over 600 physicians and scientists “is a major venue for exchanging information between OB/GYNs and hematologists,” he says. “By presenting different angles on widespread problems, we will be able to bring about great change in this field."

Prof. Brenner also moves beyond the sphere of thrombosis and women to explore the connection between coagulation and common diseases such as diabetes and cancer, studying mechanisms of major vascular complications including pulmonary embolism, Heart attacks and strokes.