Low molecular weight heparin use in unexplained recurrent miscarriage
- PMID: 25674114
- PMCID: PMC4320706
- DOI: 10.12669/pjms.306.5477
Low molecular weight heparin use in unexplained recurrent miscarriage
Abstract
Objective: The aim of the study was to investigate whether the use of low molecular weight heparin (LMWH) improve live birth rates when compared with control group in patients with unexplained recurrent miscarriages (URM).
Methods: In this prospective observational study 150 women with a history of two or more previous unexplained first trimester pregnancy loss who received LMWH; either enoxaparin (n=50), tinzaparin (n=50) or nothing (n=50) were followed for the pregnancy outcome measures. Only the patients who have used standardized dosage of LMWH (4000 IU/day enoxaparin or 3500 IU/day tinzaparin ) were included to the study. The primary end point was the live birth rate and secondary end points were the side effects, late pregnancy complications and neonatal outcome in the study cohorts.
Results: Live birth was achieved 85% of the LMWH group and 66% of the control group (p=0.007). According to the subgroup analysis; live birth rates did not differ significantly between the enoxaparin and tinzaparin group (84% and 86%, respectively). Maternal and neonatal side effects were not statistically significant among the study participants.
Conclusion: Thromboprophylaxis with LMWH resulted in a improved live-birth rate in patient with 2 or more consecutive unexplained recurrent pregnancy loss. Nevertheless these findings need to be confirmed in larger randomized trials.
Keywords: Enoxaparin; Live birth rate; Tinzaparin; Unexplained recurrent miscarriage.
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References
-
- Brenner B, Hoffman R, Blumenfeld Z, Weiner Z, Younis J. Gestational outcome in thrombophilic women with recurrent pregnancy loss treated by enoxaparin. Thromb Haemost. 2000;83:693–697. - PubMed
-
- Brenner B. Inherited thrombophilia and pregnancy loss. Best Pract Res Clin Haematol. 2003;16:311–320. - PubMed
-
- Giancotti A, La Torre R, Spagnuolo A, D’Ambrosio V, Cerekja A, Piazze J, et al. Efficacy of three different antithrombotic regimens on pregnancy outcome in pregnant women affected by recurrent pregnancy loss. J Maternal-Fetal Neonatal Med. 2012;25(7):1191–1194. - PubMed
-
- Farquharson RG, Jauniaux E, Exalto N. ESHRE Special Interest Group for Early Pregnancy (SIGEP) Updated and revised nomenclature for description of early pregnancy events. Human Reproduction. 2005;20:3008–3011. - PubMed
-
- Clark P, Walker ID, Langhorne P, et al. SPIN (Scottish Pregnancy Intervention) study: a multicenter, randomized controlled trial of low-molecular-weight heparin and low-dose aspirin in women with recurrent miscarriage. Blood. 2010;115:4162–4167. - PubMed
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