Document Detail


Enoxaparin-metformin and enoxaparin alone may safely reduce pregnancy loss.
MedLine Citation:
PMID:  19100956     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Polycystic ovary syndrome (PCOS), thrombophilia, and hypofibrinolysis are associated with recurrent pregnancy loss (RPL) and spontaneous abortion (SAB). In 28 Caucasian women, 21 women with PCOS (4 with previous thrombosis, 18 with 1 SAB or more, and 20 with 1 coagulation disorder or more), and 7 women with coagulation disorders-thrombi, we speculated that prospective treatment with enoxaparin-metformin or enoxaparin alone would successfully and safely promote healthy live births compared with previous untreated pregnancies. In 21 women with PCOS, metformin (1.5-2.55 g/day) was given before and during pregnancy with concurrent enoxaparin (60 mg/day). Of 21 PCOS women, 19 women had 40 previous untreated pregnancies, 7 had live births (18%), 3 had elective abortions (ABs) (8%), and 30 had SABs (75%). On enoxaparin-metformin, these 19 women had 24 pregnancies, 20 live births (83%), and 4 SABs (17%); the SAB rate was 4.4-fold lower than previous untreated pregnancies (McNemar's s = 20.8, P < 0. 0001). Two women with PCOS without previous pregnancies, but with previous thrombosis, had 2 pregnancies on enoxaparin-metformin and 2 live births. Of the 7 women with coagulation disorders-thrombi, 4 had 15 previous pregnancies without enoxaparin, with 6 live births (40%), 8 SABs (53%), and 1 elective AB (7%). On enoxaparin, these 4 women had 4 pregnancies, with 4 (100%) live births (McNemar's s = 8.0, P = 0.005). The other 3 women with coagulation disorders-thrombi had 4 pregnancies on enoxaparin with 4 live births. No adverse maternal-fetal side effects were reported on enoxaparin alone or enoxaparin-metformin. Enoxaparin-metformin reduces pregnancy loss in women with PCOS-coagulation disorders and in women with coagulation disorders-thrombi.
Authors:
Ganga Ramidi; Naseer Khan; Charles J Glueck; Ping Wang; Naila Goldenberg
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-12-04
Journal Detail:
Title:  Translational research : the journal of laboratory and clinical medicine     Volume:  153     ISSN:  1931-5244     ISO Abbreviation:  Transl Res     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2008-12-22     Completed Date:  2009-03-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101280339     Medline TA:  Transl Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  33-43     Citation Subset:  AIM; IM    
Affiliation:
Cholesterol Center, Jewish Hospital, Cincinnati, OH 45229, USA.
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MeSH Terms
Descriptor/Qualifier:
Abortion, Habitual / etiology,  prevention & control
Abortion, Spontaneous / etiology,  prevention & control*
Adult
Anticoagulants / therapeutic use*
Blood Coagulation Disorders / drug therapy*,  etiology
Dose-Response Relationship, Drug
Drug Therapy, Combination
Embryo Loss / etiology,  prevention & control
Enoxaparin / therapeutic use*
Female
Humans
Hypoglycemic Agents / therapeutic use*
Live Birth
Metformin / therapeutic use*
Polycystic Ovary Syndrome / complications,  drug therapy*
Pregnancy
Pregnancy Complications, Hematologic / drug therapy*
Prospective Studies
Treatment Outcome
Young Adult
Grant Support
ID/Acronym/Agency:
//Medical Research Council
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Enoxaparin; 0/Hypoglycemic Agents; 657-24-9/Metformin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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