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Indian Journal of Obstetrics and Gynecology

Volume  7, Issue 2, April-June 2019, Pages 293-301
 

Original Article

Role of Low Molecular Weight Heparin and Aspirin in Women With Recurrent Pregnancy Loss

Sushila Khoiwall, Rekha Garasiya2, Shruti3

1Senior Professor and Unit Head, 2,3Resident, Department of Obstetrics and Gynaecology, RNT Medical College, Udaipur, Rajasthan 313001, India.

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DOI: DOI: http://dx.doi.org/10.21088/ijog.2321.1636.7219.29

Abstract

Introduction: It has been proved that a successful pregnancy outcome depends on the development and maintenance of adequate uteroplacental circulation and that the hypercoagulability associated with thrombophilia might result in recurrent miscarriages. Due to the potential involvement of thrombophilia in recurrent miscarriage, the use of antithrombotic agents has been suggested as a potential means of increasing the live birth rates in subsequent pregnancies in women with either inherited thrombophilia or unexplained recurrent miscarriages. Thus, the main purpose of this work is to evaluate the effectiveness of LMWH and Aspirin to improve live birth rate in patients with recurrent pregnancy loss by seeing the outcome of the foetus in; Foetal weight, Mode of delivery, and Perinatal outcome. Methodology: A prospective observational study conducted on 100 pregnant women with a history of recurrent pregnancy loss admitted to Department of Obstetrics and Gynecology at Panna Dhai Mahila Chikitsalaya, Udaipur during the period January 2017 to February 2018. Administration of LMWH (inj. enoxaparin 40 mg s.c. OD) & tab aspirin 75 mg OD from USG confirmation of early intrauterine pregnancy till 34 weeks. Results: Patients between age 21 and 40 years were included with the mean age of 29.28 years. The mean BMI with relation to birth weight was 23.11 kg/m2. Twenty-two per cent of patients were found to be H/O IUD positive. Mode of delivery for 52% of the patients was LSCS, while for 44% of the patients it was vaginal. Two per cent of the births resulted in neonatal deaths, 4% of the pregnancies resulted in spontaneous abortion, 1% of the deliveries resulted in fresh still birth and the remaining 93% of the births resulted in survival to hospital discharge. Conclusion: Use of LMWH and tab aspirin daily in patients with RPL due to antiphospholipid syndrome resulted in higher live birth rates. Combination treatment with aspirin and LMWH leads to improve live birth rate among women with recurrent abortion and antiphospholipid antibodies.


Keywords : LMWH; Antiphospholipid antibodies; Recurrent Pregnancy Loss; Aspirin.
Corresponding Author : Rekha Garasiya