Antiphospholipid antibody–associated recurrent pregnancy loss: Treatment with heparin and low-dose aspirin is superior to low-dose aspirin alone

• Published in: American journal of obstetrics and gynecology 1996-05, Vol.174 (5), p.1584-1589
• Main Author: Kutteh, William H.
• Format: Article
• Language: English
• Subjects: Abortion, Habitual - drug therapy; Abortion, Habitual - etiology; Abortion, Habitual - immunology; Adult; antiphospholipid antibodies; Antiphospholipid Syndrome - complications; Antiphospholipid Syndrome - drug therapy; Antiphospholipid Syndrome - immunology; Aspirin - administration & dosage; Aspirin - therapeutic use; Biological and medical sciences; Diseases of mother, fetus and pregnancy; Drug Therapy, Combination; Female; Gynecology. Andrology. Obstetrics; heparin; Heparin - therapeutic use; Humans; low-dose aspirin; Medical sciences; Pregnancy; Pregnancy Complications - drug therapy; Pregnancy Complications - immunology; Pregnancy Outcome; Pregnancy. Fetus. Placenta; Prospective Studies; Recurrent pregnancy loss
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/S0002-9378(96)70610-5

OBJECTIVE: The purpose of this study was to compare the use of low-dose aspirin alone with heparin and low-dose aspirin in the treatment of the antiphospholipid antibody syndrome. STUDY DESIGN: A prospective, single-center trial included 50 patients who were alternately assigned to treatment. Each patient had at least three consecutive spontaneous pregnancy losses, positive antiphospholipid antibodies on two occasions, and a complete evaluation. Data were compared by χ 2 analysis and Fisher's exact test. RESULTS: Viable infants were delivered of 11 of 25 (44%) women treated with aspirin and 20 of 25 (80%) women treated with heparin and aspirin ( p < 0.05). There were no significant differences between the low-dose aspirin and the heparin plus low-dose aspirin groups with respect to gestational age at delivery (37.8 ± 2.1 vs 37.2 ± 3.4 weeks), number of cesarean sections (18% vs 20%), or complications. CONCLUSION: Heparin plus low-dose aspirin provides a significantly better pregnancy outcome than low-dose aspirin alone does for antiphospholipid antibody–associated recurrent pregnancy loss. (AM J OBSTET GYNECOL 1996;174:1584-9.)