Evaluation of the Efficacy of Aspirin and Low Molecular Weight Heparin in Patients with Unexplained Recurrent Spontaneous Abortions

Background: The roles of inflammatory cytokines and local placental thrombosis in patients with unexplained recurrent spontaneous abortion (URSA) have been shown. Since low molecular weight heparin (LMWH) and acetyl salicylic acid (ASA) have both anti-inflammatory and anti-coagulant effect, we evaluated their efficacy in patients with URSA. Methods: One hundred patients with a history of URSA referring to Obstetrics Clinic affiliated to Shiraz University of Medical Sciences between 2004 and 2009 were randomly divided into two groups. Fifty patients in thromboprophylaxis group were treated with LMWH (5000 unit; twice a day), ASA (80 mg daily) and calcium supplement (500 mg daily) after detection of fetal heart beat. Another 50 patients received no thromboprophylaxis. Live birth rate, obstetrical complications, prenatal and neonatal complications and hemorrhagic side effects were recorded. Results: Both groups were matched for mean age and mean number of pervious abortions. Thromboprophylaxis group had a higher rate of live birth (83.7%) in comparison to the control group (54%). No maternal or neonatal side effects were seen. There were no differences in obstetrical complications, prenatal and neonatal complications between the two groups. Conclusion: Thromboprophylaxis with ASA and LMWH seems to be safe and effective in patients with URSA.