English

Abstract

BACKGROUND: Recurrent miscarriage is a major women's health problem. Aspirin and heparin have been shown to have potentially beneficial effects on trophoblast implantation. However, few published data on this issue are available from developing countries. No significant side effects of the treatments could be evidenced in patients or newborns with both drugs. METHODS: An open clinical trial was conducted at the Department of Obstetrics and Gynecology at KIMSDU, Karad from January 2011 to December 2012 to investigate the effects of treatment with low dose aspirin (LDA) versus treatment with low-molecular-weight-heparin (LMWH) in combination with LDA on patients with a history of recurrent miscarriages. A total of 150 women were enrolled in the study. Women were eligible for the study if they had a history of three or more consecutive miscarriages. Participants were randomly assigned to receive either LDA (75 mg daily) alone or a combination of LDA and LMWH (75 women per treatment group). The primary outcomes were the rate of miscarriages and live births for each group. RESULTS: Compared with the group who received LDA alone, the combination group had a significantly lower number of miscarriages (24/75 (32%) vs. 41/75 (54%), P < 0.001) and had a significantly higher number of live births (52/75 (69%) vs. 31/75 (41%), P< 0.001). Two preterm infants in the LDA group and three in the combination group were admitted to the neonatal intensive care unit. There were no significant differences in the mean (SD) birth weights of neonates born in either group (2950.4 ±565 vs. 3000 ± 540 g for the LDA and combination groups, respectively, P = 0.444). There were no congenital abnormalities detected in either group. CONCLUSION: The combination of LDA and LMWH is better than LDA alone for the maintenance of pregnancy in patients with recurrent first trimester miscarriage.