Document Detail


Antiphospholipid antibodies associated with recurrent pregnancy loss: prospective, multicenter, controlled pilot study comparing treatment with low-molecular-weight heparin versus unfractionated heparin.
MedLine Citation:
PMID:  15749498     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the use of low-molecular-weight heparin (LMWH) in combination with low-dose aspirin (LDA) for the treatment of antiphospholipid antibody (APA)-associated recurrent pregnancy loss and to compare the results with the use of unfractionated heparin (UFH) plus LDA. DESIGN: Prospective, controlled, multicenter pilot study. SETTING: Two academically based reproductive health centers. PATIENT(S): Patients with three or more pregnancy losses and positive APA. INTERVENTION(S): Patients were treated with LMWH and LDA (n = 25) or UFH and LDA (n = 25). MAIN OUTCOME MEASURE(S): Fetal outcome and maternal complications from treatments were compared between the two treatment groups. RESULT(S): Of the 25 patients in the LMWH group, 21 (84%) delivered a viable infant and 4 (16%) miscarried. Of the 25 patients in the UFH group, 20 (80%) delivered a viable infant and 5 (20%) miscarried. These differences were not statistically significant. No major bleeding episodes occurred during pregnancy or at the time of delivery. No cases of deep venous thrombosis, thrombocytopenia, pre-eclampsia, gestational diabetes, or bone fractures were noted in either of the two groups. CONCLUSION(S): In this pilot study, the use of LDA in combination with LMWH during pregnancy for the prevention of recurrent pregnancy loss in women with antiphospholipid syndrome seems to be as safe as UFH plus LDA. Large, randomized trials will be required to determine differences in outcome with LMWH and LDA compared with treatment with UFH combined with LDA in this group of patients.
Authors:
Luis S Noble; William H Kutteh; Nanette Lashey; Rodney D Franklin; Juan Herrada
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article; Multicenter Study    
Journal Detail:
Title:  Fertility and sterility     Volume:  83     ISSN:  0015-0282     ISO Abbreviation:  Fertil. Steril.     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-03-07     Completed Date:  2005-05-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  United States    
Other Details:
Languages:  eng     Pagination:  684-90     Citation Subset:  IM    
Affiliation:
Department of Obstetrics, Texas Tech University Health Sciences Center, El Paso, Texas, USA.
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MeSH Terms
Descriptor/Qualifier:
Abortion, Habitual / immunology*,  prevention & control*
Adult
Antibodies, Antiphospholipid / blood*
Anticoagulants / administration & dosage*,  adverse effects
Aspirin / administration & dosage,  adverse effects
Drug Therapy, Combination
Female
Heparin, Low-Molecular-Weight / administration & dosage*,  adverse effects
Humans
Pilot Projects
Platelet Aggregation Inhibitors / administration & dosage,  adverse effects
Pregnancy
Pregnancy Complications / immunology,  prevention & control
Pregnancy Outcome
Premature Birth
Prospective Studies
Chemical
Reg. No./Substance:
0/Antibodies, Antiphospholipid; 0/Anticoagulants; 0/Heparin, Low-Molecular-Weight; 0/Platelet Aggregation Inhibitors; 50-78-2/Aspirin

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