Role of Low Molecular Weight Heparin and Aspirin in Women with Recurrent Pregnancy Loss
Authors/Creators
- 1. Junior Specialist Obstetrics and Gynaecology, Govt Medical Center & attached Bangur Hospital, Pali, Rajasthan
- 2. Assistant Professor, Anaesthesiology Govt Medical Center & attached Bangur Hospital, Pali, Rajasthan
Description
Background: Recurrent miscarriage is one of them that affecting the health of the women. The term recurrent miscarriage refers to two or more consecutive pregnancy losses before 20 weeks of gestation. These kinds of issues are reported among 5% of women at reproductive age and the etiology of 68% of recurrent abortions. Enoxaparin is the most commonly used agent in the existing trials. Tinzaparin sodium is also a LMWH and, its biochemical and pharmacokinetic differences from enoxaparin may have clinically important effects. The data about the administration of tinzaparin during pregnancy is limited. However, LMWH alone throughout the pregnancy in patients with URM has not been sufficiently investigated and also, there is a lack of evidence for comparing LMWH molecules in these patients. Aim: The study aims to analyze the role of low molecular weight heparin and aspirin in women with recurrent pregnancy loss. Method: This was a prospective observational study conducted on 100 pregnant women with history of recurrent pregnancy loss admitted to Department of Obstetrics and Gynecology at Govt Medical Center & attached Bangur Hospital, Pali, Rajasthan, during the period March 2019 to December 2021. The inclusion criteria for the study involve age- 18-40 yrs, history of unexplained spontaneous recurrent abortion (2 or more), Antiphospholipid antibody positive, current pregnancy and cardiac activity confirmed by USG report. Apart from this, exclusion criteria were involving the known case of aneuploidy, anomaly, ectopic pregnancy, multiple pregnancies. Women with Cardiovascular disease, bleeding diathesis, previous thromboembolic phenomena, diabetes mellitus and other contraindication to LMWH. Results: For the current study, 27% of the patients belonged to 21-25 years of age group following which 37% of the patients belonged to 26-30 years of age group. 19% of the patients belonged to 31-35 years of age group while the remaining 17% of the patients belonged to 36-40 years of age group. Moreover, 96% of the patients’ belonged to normal BMI range while the remaining 4% of the patients belonged to overweight BMI range. Hypertensive Disorders (i.e. BP ≥ 140/90). 15% of the patients were detected with Precious Pregnancy/Precious Pregnancy with CRN, 6% of the patients were detected with Fetal Distress, 3% of the patients were detected with Oligo, 5% of the patients were detected with IUGR, 8% of the patients were detected with Pre-eclampsia/Pre-eclampsia with IUGR. Conclusion: From the study, it has been concluded that LMWH resulted in an improved live-birth rate in patient with 2 or more consecutive unexplained recurrent pregnancy loss. Nevertheless these findings need to be confirmed in larger randomized trials. Tinzaparin sodium is also a LMWH.
Abstract (English)
Background: Recurrent miscarriage is one of them that affecting the health of the women. The term recurrent miscarriage refers to two or more consecutive pregnancy losses before 20 weeks of gestation. These kinds of issues are reported among 5% of women at reproductive age and the etiology of 68% of recurrent abortions. Enoxaparin is the most commonly used agent in the existing trials. Tinzaparin sodium is also a LMWH and, its biochemical and pharmacokinetic differences from enoxaparin may have clinically important effects. The data about the administration of tinzaparin during pregnancy is limited. However, LMWH alone throughout the pregnancy in patients with URM has not been sufficiently investigated and also, there is a lack of evidence for comparing LMWH molecules in these patients. Aim: The study aims to analyze the role of low molecular weight heparin and aspirin in women with recurrent pregnancy loss. Method: This was a prospective observational study conducted on 100 pregnant women with history of recurrent pregnancy loss admitted to Department of Obstetrics and Gynecology at Govt Medical Center & attached Bangur Hospital, Pali, Rajasthan, during the period March 2019 to December 2021. The inclusion criteria for the study involve age- 18-40 yrs, history of unexplained spontaneous recurrent abortion (2 or more), Antiphospholipid antibody positive, current pregnancy and cardiac activity confirmed by USG report. Apart from this, exclusion criteria were involving the known case of aneuploidy, anomaly, ectopic pregnancy, multiple pregnancies. Women with Cardiovascular disease, bleeding diathesis, previous thromboembolic phenomena, diabetes mellitus and other contraindication to LMWH. Results: For the current study, 27% of the patients belonged to 21-25 years of age group following which 37% of the patients belonged to 26-30 years of age group. 19% of the patients belonged to 31-35 years of age group while the remaining 17% of the patients belonged to 36-40 years of age group. Moreover, 96% of the patients’ belonged to normal BMI range while the remaining 4% of the patients belonged to overweight BMI range. Hypertensive Disorders (i.e. BP ≥ 140/90). 15% of the patients were detected with Precious Pregnancy/Precious Pregnancy with CRN, 6% of the patients were detected with Fetal Distress, 3% of the patients were detected with Oligo, 5% of the patients were detected with IUGR, 8% of the patients were detected with Pre-eclampsia/Pre-eclampsia with IUGR. Conclusion: From the study, it has been concluded that LMWH resulted in an improved live-birth rate in patient with 2 or more consecutive unexplained recurrent pregnancy loss. Nevertheless these findings need to be confirmed in larger randomized trials. Tinzaparin sodium is also a LMWH.
Files
IJPCR,Vol14,Issue6,Article24.pdf
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Additional details
Dates
- Accepted
-
2022-06-05
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/14/IJPCR,Vol14,Issue6,Article24.pdf
- Development Status
- Active
References
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