DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20174652

The effect of low dose aspirin and low molecular weight heparin (enoxaparin) in recurrent pregnancy loss associated with antiphospholipid antibody syndrome

Sasmita Swain, Sujata Singh

Abstract


Background: Recurrent miscarriage affects 1–2% of women. Recurrent pregnancy loss (RPL) is the loss of three or more consecutive pregnancies before or during the 20th week of gestation. The most important association between gestational loss and autoimmune phenomena is the presence of antiphospholipid antibodies represented by the lupus anticoagulants and or anticardiolipin antibodies (Antiphospholipid Antibody Syndrome). The antiphospholipid syndrome is an acquired autoimmune. The clinical features are thrombosis (venous, arterial and microvascular) and/or pregnancy complications; the most prominent of which is recurrent abortion.

Methods: Twenty-two selected patients during pregnancy with clinical and/or serological findings of antiphospholipid syndrome had received low dose aspirin (75 mg once daily orally) plus LMWH enoxaparin (40 mg subcutaneously/day).

Results: There are live born in 86% cases compared to abortion (< 20 weeks gestational age) in 14 % cases. From 19 liveborn babies the mother having normotensive in 79% and preeclampsia 21%, 85% babies having normal growth and 15% are IUGR. 36% cases are at term (>37 weeks) and 50% cases are at preterm (<37 week) on which 9%) is spontaneous preterm and 41% is iatrogenic preterm due to preeclampsia, IUGR, PPROM and APH.

Conclusions: Use of low dose aspirin (75mg) and enoxaparin 40 mg subcutaneously daily in patients with RPL due to antiphospholipid syndrome resulted in higher live birth rates. Combination treatment with aspirin and LMWH leads to a high live birth rate among women with recurrent abortion and antiphospholipid antibodies.

 


Keywords


aPL, APS, APA, IUGR, LDA, LMWA, RPL

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References


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