Document Type : Original Research Article

Authors

• Malihe Afiat ¹
• Nayere Khadem ¹
• Behnaz Ansari ¹
• Fedyeh Haghollahi ²
• Mohadese Dashtkoohi ³
• Mohammad Sadeq Najafi ⁴
• Mohammad Dashtkoohi ⁴
• MirFarbod Hojati Bagheri ⁵
• Seyede Houra Mousavi Vahed ¹

¹ Department of Obstetrics and Gynecology, School of Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

² Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran

³ Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran.

⁴ Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran

⁵ Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences

Abstract

Background and Objective: The effectiveness of aspirin and heparin in improving live birth rates in unexplained recurrent pregnancy loss remains uncertain, and further research is needed on using low molecular weight heparins (LMWH) through randomized clinical trials. This study aims to assess the impact of enoxaparin, an LMWH, and its outcomes in women with URPL.

Methods: This study presents a single-blinded randomized clinical trial involving 80 women with URPL and no history of thrombophilia. The participants were referred to the Infertility Clinic at Imam Reza Hospital (Milad Center) between March 2018 and February 2019. During the sixth week of gestation, the participants were assigned randomly to two groups. The treatment group (n = 40) received a daily subcutaneous injection of 40 mg of enoxaparin, while the control group (n = 40) received routine pregnancy care. Maternal and neonatal demographic data, pregnancy outcomes, complications, and live birth rates were recorded and subsequently compared between the two groups.

Results: A total of 80 eligible women were enrolled in the study, with equal distribution between the treatment and control groups. There were no significant differences in previous pregnancies or miscarriages between the groups, and the live birth rate was about 85% in both groups. The occurrence of pregnancy complications was significantly higher in the treatment group compared to the control group (38.2% VS. 5.7%; p = 0.021).

Conclusion: Treatment with enoxaparin in women with unexplained recurrent pregnancy loss and no history of thrombophilia did not improve the pregnancy outcome nor decrease pregnancy complications.

Keywords

• Keywords: Recurrent Pregnancy Loss
• Antiphospholipid Syndrome
• Enoxaparin
• Low Molecular Weight Heparin

Main Subjects

• Obstetrics and Gynecology