Outpatient management of placental insufficiency with heparin.

1t has been demonstrated that continuous administration of heparin during pregnancy results in an improvement of placental insufficiency [l, 2, 3, 4, S]. This is based on the assumption that the nutritional insufficiency is caused maintained by a disturbance in the microcirculation due to platelet aggregation and fibrin deposits. By inhibiting these coagulation processes the disturbances of metabolic exchange might be alleviated. Generally, the method has been to admit patients to the hospital and save for some exceptions [1] to administer heparin by constant infusion (2040,000 lU/day). While this method is rational it has the great disadvantage of requiring long-term hospitalization which even highJy motivated patients are often unable to accept. Based on the experiences with the post-operative prophylaxis of thrombosis with heparin in intermittent low doses subcutaneously we have attempted to treat cases of placental insufficiency in this fashion äs well. We expected these results to be less successful than those with continuous infusions with heparin; the method nevertheless is more practical.