Anticoagulant Therapy in Primary and Secondary Recurrent Pregnancy Losses with Hereditary Thrombophilia and Perinatal Outcomes

Abstract

Objective: To investigate the effect of anticoagulant treatment and perinatal outcomes in patients with primary or secondary recurrent pregnancy loss without cause other than inherited trombophilia. Methods: A total of 143 pregnant patients with recurrent pregnancy loss (≥2 abortus) and had no detected cause other than thrombophilia, were included in the study. Patients with no livebirth history were accepted as primary and patients with at least one livebirth were as secondary recurrent spontaneous aborters (PrimRSAs and SecRSAs). Inherited thrombophilia genetic results of the patients in both groups were compared. The effects of low-molecular weight heparin (LMWH) and low-dose aspirin (LDA) treatments alone or together, livebirth rates and pregnancy outcomes were investigated. Results: Sixty-eight patients were in PrimRSAs and 75 were in SecRSAs. Ages, numbers of total, early and late pregnancy loss of both groups were similar. In PrimRSAs 49 (72.1%) and in SecRSAs 50 (66.6%) patients had three or more inherited thrombophilia genetic mutations. Of 113 patients who used LMWH+LDA during pregnancy 88 (77.6%) had livebirth; however, of 19 patients who used LMWH 6 (31.6%) and of 11 women who used LDA 8 (72.7%) had livebirth. Livebirth rate was significantly higher in patients who used LMWH+LDA together (p=0.001). Livebirth rates were higher in SecRSAs than PrimRSAs irrespective to the anticoagulant treatment (p=0.002). Conclusion: LMWH and LDA treatment together may increase livebirth rates in patients with recurrent pregnancy loss and inherited thrombophilia. Having at least one livebirth of the patients is a good prognostic factor. J Clin Exp Invest 2016; 7 (1): 29-34