Volume 12, Issue 1 (2-2014)                   IJRM 2014, 12(1): 73-76 | Back to browse issues page

XML Persian Abstract Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Ghasemi N, Jahaninejad T, Mostafavi M, Aflatoonian A. Effectiveness of aspirin compare with heparin plus aspirin in recurrent pregnancy loss treatment: A Quasi experimental study. IJRM 2014; 12 (1) :73-76
URL: http://ijrm.ir/article-1-470-en.html
Effectiveness of aspirin compare with heparin plus aspirin in recurrent pregnancy loss treatment: A Quasi experimental study
Nasrin Ghasemi * 1, Tahereh Jahaninejad2 , Mahdia-sadat Mostafavi3 , Abbas Aflatoonian3
1- Department of Medical Genetics, Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran , n479g@yahoo.co.uk
2- Department of Medical Genetics, Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
3- Department of Obstetrics and Gynecology, Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Abstract:   (2597 Views)
Background: Using aspirin, heparin, or both in women with unexplained recurrent miscarriage could be useful, because this problem might be initiated by thrombosis in decidual vessels.
Objective: To investigate the association between thrombophilia and unexplained recurrent miscarriage and to evaluate the efficacy of anticoagulant treatment.
Materials and Methods: In this quasi experimental, we enrolled 520 women, who had a history of recurrent miscarriage. Two hundred fifty two women with unexplained recurrent miscarriage were assigned to receive aspirin (80 mg daily) for two month before pregnancy and after confirmation of a viable pregnancy until 36 weeks of gestation or receive aspirin, as the same, plus heparin (5000 unit twice a day) subcutaneously after confirmation of viable pregnancy until 4 weeks after delivery. Type of medication was chosen for each woman according to number of abortion and age.
Results: Live-birth rates did not different significantly among the two study groups. The proportions of women who gave birth to a live normal infant were 74.5% in the group receiving aspirin plus heparin (combination-therapy group) and 79.8% in the aspirin group.
Conclusion: Live-birth rates did not different significantly among the two study groups. So, using aspirin or aspirin plus heparin did not change pregnancy rate in these patients. Using aspirin is easier than injecting heparin which should be chosen case by case.
Keywords: Thrombophilia, Recurrent miscarriage, Anticoagulant, Live birth, Aspirin, Heparin.
Full-Text [PDF 260 kb]   (584 Downloads) |   |   Full-Text (HTML)  (335 Views)  
Type of Study: Original Article |
References
1. Toth B, Jeschke U, Rogenhofer N, Scholz C, Würfel W, Thaler CJ, et al. Recurrent miscarriage: current concepts in diagnosis and treatment. J Reprod Immunol 2010; 85: 25-32. [DOI:10.1016/j.jri.2009.12.006]
2. Carrington B, Sacks G, Regan L. Recurrent miscarriage: pathophysiology and outcome. Curr Opin Obstet Gynecol 2005; 17: 591-597. [DOI:10.1097/01.gco.0000194112.86051.26]
3. Monien S, Kadecki O, Baumgarten S, Salama A, Dörner T, Kiesewetter H. Use of heparin in women with early and late miscarriages with and without thrombophilia. Clin Appl Thromb Hemost 2009; 15: 636-644. [DOI:10.1177/1076029609335501]
4. Rai R, Regan L. Recurrent miscarriage. Lancet 2006; 368: 601-611. [DOI:10.1016/S0140-6736(06)69204-0]
5. Redline RW. Thrombophilia and placental pathology. Clin Obstet Gynecol 2006; 49: 885-894. [DOI:10.1097/01.grf.0000211957.68745.6b]
6. Heit JA. Thrombophilia: Common Questions on Laboratory Assessment and Management. Hematology Am Soc Hematol Educ Program 2007; 1: 127-135. [DOI:10.1182/asheducation-2007.1.127]
7. Behjati R, Modarressi MH, Jeddi-Tehrani M, Dokoohaki P, Ghasemi J, Zarnani AH, et al. Thrombophilic mutations in Iranian patients with infertility and recurrent spontaneous abortion. Ann Hematol 2006; 85: 268-271. [DOI:10.1007/s00277-005-0021-0]
8. Silver RM, Warren JE. Preconception counseling for women with thrombophilia. Clin Obstet Gynecol 2006; 49: 906-919. [DOI:10.1097/01.grf.0000211959.53498.a4]
9. Mukhopadhyay R, Saraswathy KN, Ghosh PK. MTHFR C677T and factor V Leiden in recurrent pregnancy loss: a study among an endogamous group in North India. Genet Test Mol Biomarkers 2009; 13: 861-865. [DOI:10.1089/gtmb.2009.0063]
10. Brenner B. Haemostatic changes in pregnancy. Thromb Res 2004; 114: 409-414. [DOI:10.1016/j.thromres.2004.08.004]
11. Rai R, Backos M, Baxter N, Chilcott I, Regan L. Recurrent miscarriage-an aspirin a day? Hum Reprod 2000; 15: 2220-2223. [DOI:10.1093/humrep/15.10.2220]
12. Dolitzky M, Inbal A, Segal Y, Weiss A, Brenner B, Carp H. A randomized study of thromboprophylaxis in women with unexplained consecutive recurrent miscarriages. Fertil Steril 2006; 86: 362-366. [DOI:10.1016/j.fertnstert.2005.12.068]
13. Mitić G, Novakov Mikić A, Povazan L, Mitreski A, Kopitović V, Vejnović T. Thromboprophylaxis implementation during pregnancy in women with recurrent foetal losses and thrombophilia. Med Pregl 2011; 64: 471-475. [DOI:10.2298/MPNS1110471M]
14. Kaandorp SP, Goddijn M, van der Post JA, Hutten BA, Verhoeve HR, Hamulyák K, et al. Aspiri plus heparin or aspirin alone in women with recurrent miscarriage. N Engl J Med 2010; 362: 1586-1596. [DOI:10.1056/NEJMoa1000641]
15. Infante-Rivard C, David M, Gauthier R, Rivard GE. Lupus anticoagulants, anticardiolipin antibodies, and fetal loss a case-control study. N Engl J Med 1999; 325: 1063-1066. [DOI:10.1056/NEJM199110103251503]
16. Lockshin MD. Pregnancy loss in the antiphospholipid syndrome. Thromb Haemost 1999; 82: 641-648.
17. Greer IA. Antithrombotic treatment for recurrent pregnancy loss? J Thromb Haemost 2011; 9 (Suppl.): 302-305. [DOI:10.1111/j.1538-7836.2011.04313.x]
18. Kaandorp S, Di Nisio M, Goddijn M, Middeldorp S. Aspirin or anticoagulants for treating recurrent pregnancy loss in women without antiphospholipid syndrome. Cochrane Database Syst Rev 2009; (1): CD004734.
19. Laude I, Rongières-Bertrand C, Boyer-Neumann C, Wolf M, Mairovitz V, Hugel B, et al. Circulating procoagulant microparticles in women with unexplained pregnancy loss: a new insight. Thromb Haemost 2001; 85: 18-21.
20. Di Nisio M, Peters L, Middeldorp S. Aspirin or anticoagulants for treating. Cochrane Database Syst Rev 2005: CD004734.
21. Tzafettas J, Mamopoulos A, Anapliotis A, Loufopoulos A, Psarra A, Klearchou N, et al. Thromboprophylaxis throughout pregnancy in women with previous history of recurrent miscarriages of unknown aetiology. Clin Exp Obstet Gynecol 2002; 29: 267-270.
22. Deligiannidis A, Parapanissiou E, Mavridis P, Tabakoudis G, Mavroudi A, Papastavrou T, et al. Thrombophilia and antithrombotic therapy in women with recurrent spontaneous abortions. J Reprod Med 2007; 52: 499-502.
23. McNamee K, Dawood F, Farquharson RG. Thrombophilia and early pregnancy loss. Best Pract Res Clin Obstet Gynaecol 2012; 26: 91-102. [DOI:10.1016/j.bpobgyn.2011.10.002]
24. Visser J, Ulander VM, Helmerhorst FM, Lampinen K, Morin-Papunen L, Bloemenkamp KW, et al. Thromboprophylaxis for recurrent miscarriage in women with or without thrombophilia. HABENOX: a randomised multicentre trial. Thromb Haemost 2011; 105: 295-301. [DOI:10.1160/TH10-05-0334]
Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Designed & Developed by : Yektaweb