The role of aspirin versus aspirin and heparin in cases of recurrent abortions with raised anticardiolipin antibodies

Abstract

Background: The present study was undertaken to compare the role of aspirin versus aspirin plus heparin combination in pregnant women with poor obstetric history and raised anticardiolipin antibodies IgG (IgG(acl)).

Material/methods: The study was conducted on 550 pregnant women, 450 with a history of two or more spontaneous abortions forming the study group, while 100 women with one or more live births and no history of abortion were controls. Their blood was tested to assess the level of IgG(acl) by enzyme-linked immunosorbent assay (ELISA). The test was strongly positive in 72 (16%) patients of the study group, who were randomized to receive either low-dose aspirin (80 mg/day) or a combination of low-dose aspirin (80 mg/day) and 5000 IU of unfractionated heparin subcutaneously 12 hourly under hospital surveillance. The pregnancy outcomes were statistically compared.

Results: Of the 39 patients treated with low-dose aspirin, 24 (61.5%) gave birth to live issues compared with 28 (84.8%) of the 33 women given a combination of aspirin and heparin (p<0.05), an overall success rate of 72.2%. Mean birth weight of the babies given treatment with heparin and aspirin was 3.21+/-0.33 kg compared with 2.77+/-0.14 kg achieved with aspirin alone (p<0.001). Both treatments were well tolerated.

Conclusions: The study provides evidence that in cases of recurrent abortions with raised IgG(acl), treatment with a combination of aspirin and heparin showed better outcome than treatment with aspirin alone.