IDIOPATHIC RECURRENT MISCARRIAGES

Abstract

Objectives: The rationale of our study is to investigate whether aspirin alone,or aspirin combined with low molecular weight heparin as compared to placebo (intensivepregnancy surveillance), would improve the live birth rate (primary outcome) among withidiopathic recurrent miscarriages. Secondary outcomes included rate of serious adverse eventsduring pregnancy among pharmacological intervention group and intensive surveillance group:rates of miscarriage, intrauterine fetal death (fetal death after 24 weeks of gestation), small forgestational age, premature delivery, APH and PPH. Study Design: A prospective, randomized,single-blinded, placebo- controlled trial was conducted at Tertiary Referral Obstetric Hospital.Setting: Fatima Memorial Hospital, Lahore Period: 2007 to 2013. Method: The participantswere 172 women with a diagnosis of idiopathic recurrent miscarriage.12 patients dropped outof the study. Women with 2 or more recurrent fetal losses and after exclusion of all knowncauses of recurrent miscarriage were randomly allocated to receive aspirin alone (n=54),combination treatment aspirin and heparin (n=56) or placebo (n=50 intensive pregnancysurveillance). The results were analyzed by SPSS (version 17) and they were tested by chisquaretest. Results: Out of 160 women who underwent randomization, live birth rate did notdiffer significantly among the three groups. The live birth rate was 70.3% among aspirin onlygroup, 73.2% among aspirin and heparin group and 70% among intensive surveillance group(placebo) with a p value equal to 0.11. No significant differences in secondary outcome wereobserved among three groups. Conclusion: In conclusion, our findings do not support thehypotheses that use of aspirin alone or in combination with enoxapirin improves the live birthrate in women with idiopathic recurrent miscarriages.