Tafoxiparin effects on cervical ripening and labor augmentation

Introduction: Delayed onset and/or protracted labor progression is a relatively common obstetrical condition. The hypothesis that low molecular weight heparins may induce positive effects on uterine tissues in promoting and shortening delivery time was advanced in the last few years through several retrospective studies in pregnant women treated for thrombotic disorders. Tafoxiparin, a depolymerized form of heparin with a molecular structure created to eliminate the anticoagulant effects of heparins, is under investigation as a potential tool to promote labor activation and progression. Areas covered: The authors conducted a critical review on current pharmacological and clinical evidence of tafoxiparin effects on labor. Expert opinion: To date, available results may indicate potential benefits of using tafoxiparin for cervical ripening and labor augmentation, but several aspects need further clarifications and investigations. Clinical evidence is still weak to generalize the results of the trials and support the introduction of the drug into daily medical practice because few studies specifically focussing on this topic were published until now. In addition, many queries are left to be explored with future research, including optimal timing and doses, better route of administration, patient and physician acceptability, target pregnant populations, and cost-effectiveness aspects.