Aspirin Plus Heparin Versus Aspirin and Oral Prednisolone in the Management of Women with Recurrent Miscarriage
DOI:
https://doi.org/10.56981/M212Abstract
Recurrent pregnancy loss RPL is characterized by at minimum 2 or 3 consecutive losses before the 20th week of gestation. In 1percentage to 5percentage of all pregnancies.
Aim of the Work: assessing the effectiveness of low dosage aspirin and steroid therapy in the management of women with recurrent miscarriage vs. Aspirin and heparin LMWH study.
Patients and Methods: In repeated miscarriage clinics, this randomized clinical experiment was performed in the Obstetrics and Gynecology Department, in Iraqi Hospital on 50 pregnant women, who fulfilled the inclusion criteria and after taking an informed consent. Group 1: included 25 pregnant females administered with low dose aspirin 75 mg tablet (one tablet twice daily) and prednisolone 5mg two tablets twice daily (20mg). Group 2: included 25 pregnant females administered with low dose aspirin 75 mg tablet (one tablet twice daily) and heparin.
Both groups were followed in hospital recurrent miscarriage clinic every two weeks by ultrasonography from the incidence of the pregnancy till delivery.
Results: Prednisolone (PSL) plus LDA increased the live birth rate by 32.2 percent compared to group II. and according to on-going pregnancy data was in group I 37/50(74%) and in group II 21/50(42%) OR (C.I. 95% 4.128 [2.142-7.952] RR (C.I. 95%1.875 [1.401-2.505] p<0.001, between the two groups, with a substantial differential. When it came to the development of contusion, there was a substantial variance (P<0.05). among the two groups.
Conclusion: For women with idiopathic pregnancy loss, a combination of prednisone and low-dose aspirin could be a beneficial treatment.
References
1. Gharesi-Fard B, Ghadri JZ and Kamali-Sarvestani E (2014): Alteration in the Expression of Proteins in Unexplained Recurrent Pregnancy Loss Compared with in the Normal Placenta. J Reprod Dev., 60(4): 261–267.
2. Shakarami F, Akbari MT and Karizi SZ (2015): Association of plasminogen activator inhibitor-1 and angiotensin converting enzyme polymo- rphisms with recurrent pregnancy loss in Iranian women. Iran J Reprod Med., 13(10): 627–632.
3. Kashif S, Kashif MA and Saeed A (2015): The association of factor V leiden mutation with recurrent pregnancy loss. JPMA. The Journal of the Pakistan Medical Association, 65(11):1169-1172.
4. Clifford K, Rai R and Regan L (1997): Future pregnancy outcome in unexplained recurrent first trimester miscarriage. Hum Reprod., 12:387–9.
5. Nybo Andersen AM, Wohlfahrt J, Christens P et al. (2000): Maternal age and fetal loss: population based register linkage study. BMJ., 320:1708–12.
6. Sugiura-Ogasawara M, Ozaki Y and Katano K (2012): Abnormal embryonic karyotype is the most frequent cause of recurrent miscarriage. Hum Reprod., 27:2297–303.
7. Li TC, Markis M, Tomsu M et al. (2002): Recurrent miscarriage, aetiology management and prognosis. Hum Reprod Update, 8: 463 – 481.
8. Quenby S, Kalumbi C and Bates M (2005): Prednisolone reduces preconceptual endometrial natural killer cells in women with recurrent miscarriage. Fertil Steril., 84(4):980–4.
9. Tan EM, Cohen AS and Fries JF (1982): The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum., 25:1271-7.
10. Askie LM, Duley L, Henderson-Smart DJ et al. (2007): Antiplatelet agents for prevention of pre- eclampsia: a metaanalysis of individual patient data. Lancet, 369(9575): 1791–8.
11. Tulppala M, Marttunen M, Soderstrom-Anttila V et al. (1997): Low dose aspirin in the prevention of miscarriage in women with unexplained or autoimmune related recurrent miscarriage: effect on prostacyclin and thromboxane A2 production. Human Reproduction, 12(1):191.
12. Kaandorp SP, Goddijn M, van der Post JA et al. (2010): Aspirin plus heparin or aspirin alone in women with recurrent miscarriage. New England Journal of Medicine, 362(17):1586–96.
13. De Jong PG, Kaandorp S, Di Nisio M et al. (2014) Aspirin and/or heparin for women with unexplained recurrent miscarriage with or without inherited thrombophilia. doi: 10.1002/ 14651858.CD004734.
14. El Omda, F. A., Abd ElFattah, A. T., & Ragab, A. M. (2019). Combined Low Dose Aspirin and Steroids vs Aspirin Only in Management of Unexplained Recurrent Miscarriage. The Egyptian Journal of Hospital Medicine, 75(5), 2825-2832.
15. El Omda, F. A., Abd ElFattah, A. T., & Ragab, A. M. (2019). Combined Low Dose Aspirin and Steroids vs Aspirin Only in Management of Unexplained Recurrent Miscarriage. The Egyptian Journal of Hospital Medicine, 75(5), 2825-2832.
16. Ou, H., & Yu, Q. (2020). Efficacy of aspirin, prednisone, and multivitamin triple therapy in treating unexplained recurrent spontaneous abortion: A cohort study. International Journal of Gynecology & Obstetrics, 148(1), 21-26.
17. Mohamed, K. A. A., & Saad, A. S. (2014). Enoxaparin and aspirin therapy for recurrent pregnancy loss due to anti-phospholipid syndrome (APS). Middle East Fertility Society Journal, 19(3), 176-182.
18. Mohamed, K. A. A., & Saad, A. S. (2014). Enoxaparin and aspirin therapy for recurrent pregnancy loss due to anti-phospholipid syndrome (APS). Middle East Fertility Society Journal, 19(3), 176-182.
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