Department of Obstetrics and Gynecology, Faculty of medicine, Cairo University, Cairo, Egypt.
Int J Gynaecol Obstet. 2011 Mar;112(3):211-5. doi: 10.1016/j.ijgo.2010.09.010. Epub 2011 Jan 19.
To determine whether low molecular weight heparin (LMWH) plus low-dose aspirin (LDA) is comparable in efficacy and safety to unfractionated heparin (UFH) plus LDA in the management of pregnant women with a history of recurrent spontaneous abortion secondary to antiphospholipid syndrome (APS).
In a randomized prospective study, 60 women with a history of 3 or more consecutive spontaneous abortions and positive antiphospholipid antibodies were assigned in equal numbers to receive either UFH (5000 units, twice daily) plus LDA, or LMWH (enoxaparin 40 mg, once daily) plus LDA as soon as pregnancy was diagnosed.
Twenty-four women in the LMWH group (80%) and 20 women in the UFH group (66.67%) delivered a viable infant (P = 0.243). There were no significant differences in pregnancy complications or neonatal morbidity between the 2 groups. There were no incidences of excessive bleeding, thrombocytopenia, or osteoporotic fractures in either group.
LMWH plus LDA was successfully used as an alternative to UFH plus LDA in the management of recurrent abortion secondary to APS. The results highlight the need for a larger randomized controlled trial to determine whether LMWH plus LDA should be the treatment of choice for recurrent abortion secondary to APS. Clinicaltrials.gov NCT01051778.
确定低分子量肝素（LMWH）联合小剂量阿司匹林（LDA）与普通肝素（UFH）联合 LDA 在治疗因抗磷脂综合征（APS）导致复发性自发性流产史的孕妇中的疗效和安全性是否相当。
在一项随机前瞻性研究中，将 60 名有 3 次或以上连续自发性流产史且抗磷脂抗体阳性的女性等分为两组，分别给予 UFH（5000 单位，每日两次）联合 LDA 或 LMWH（依诺肝素 40mg，每日一次）联合 LDA，一旦确诊怀孕即开始治疗。
LMWH 组 24 名女性（80%）和 UFH 组 20 名女性（66.67%）成功分娩出活婴（P=0.243）。两组的妊娠并发症或新生儿发病率无显著差异。两组均未发生过度出血、血小板减少或骨质疏松性骨折。
LMWH 联合 LDA 可成功替代 UFH 联合 LDA 用于治疗因 APS 导致的复发性流产。研究结果强调需要进行更大规模的随机对照试验，以确定 LMWH 联合 LDA 是否应成为因 APS 导致的复发性流产的首选治疗方法。Clinicaltrials.gov NCT01051778。
