Randomized study of subcutaneous low molecular weight heparin plus aspirin versus intravenous immunoglobulin in the treatment of recurrent fetal loss associated with antiphospholipid antibodies
✍ Scribed by Giovanni Triolo; Angelo Ferrante; Francesco Ciccia; Antonina Accardo-Palumbo; Antonino Perino; Antonio Castelli; Antonio Giarratano; Giuseppe Licata
- Publisher
- John Wiley and Sons
- Year
- 2003
- Tongue
- English
- Weight
- 54 KB
- Volume
- 48
- Category
- Article
- ISSN
- 0004-3591
No coin nor oath required. For personal study only.
✦ Synopsis
Abstract
Objective
To compare the 2 most efficacious therapeutic regimens, intravenous immunoglobulin (IVIG) and anticoagulation with low molecular weight (LMW) heparin plus low‐dose aspirin, in women with recurrent pregnancy loss associated with antiphospholipid antibodies (aPL).
Methods
We examined 40 women with recurrent abortion (at least 3 occurrences) and repeatedly positive test results for anticardiolipin or lupus anticoagulant. The subjects were randomly assigned to treatment with IVIG or LMW heparin plus low‐dose aspirin. Both therapies were started when the women were pregnant as documented by a positive urine test. IVIG was stopped at the thirty‐first week of gestation, aspirin at the thirty‐fourth week, and heparin at the thirty‐seventh week. The primary outcome of interest was the rate of live births with the 2 treatments.
Results
The characteristics of the 2 groups were similar at the time of randomization. The women treated with LMW heparin plus low‐dose aspirin had a higher rate of live births (84%) than those treated with IVIG (57%).
Conclusion
Treatment with LMW heparin plus low‐dose aspirin should be considered as the standard therapy for recurrent pregnancy loss due to aPL.