Awolumate Oluwatayo J, Kang Ayesha, Khokale Rhutuja, Cancarevic Ivan
Family Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Cureus. 2020 Oct 15;12(10):e10956. doi: 10.7759/cureus.10956.
Recurrent pregnancy loss remains a significant challenge in gynecological practice, accounting for about 2%-4% of pregnancies. In some patients, the etiology is unknown. Unexplained recurrent pregnancy loss (URPL) refers to the spontaneous loss of three or more consecutive pregnancies without an identifiable risk factor, accounting for about 40%-50% of pregnancy losses. The review aims to understand the role of low molecular weight heparin (LMWH) in the treatment of URPL. Articles for this review have been found in the PubMed database, and studies published more than ten years before the review excluded. The articles were reviewed to determine the effect of LMWH on live birth rates, reduced late pregnancy complications, and adverse drug reactions following its use. Many studies show improved live birth rates in women treated with LMWH compared to the control, while some studies show no improvement. There was no statistically significant difference in reducing late pregnancy complications, such as preeclampsia, intrauterine growth restriction, preterm labor, and low birth weight, in either study and control groups. Adverse drug reaction was rare among women treated with LMWH and, if present, was mild and self-limiting, thus making it a safe therapy. More studies, preferably large multicenter randomized controlled trials, need to be conducted on the use of LMWH to establish a consensus guideline on the treatment of URPL.
复发性流产仍然是妇科临床中的一个重大挑战，约占妊娠总数的2%-4%。在一些患者中，病因不明。不明原因复发性流产（URPL）是指连续发生三次或三次以上自然流产且无明确危险因素，约占流产病例的40%-50%。本综述旨在了解低分子量肝素（LMWH）在URPL治疗中的作用。本综述的文章来自PubMed数据库，排除了在综述前十年以上发表的研究。对这些文章进行综述，以确定LMWH对活产率、减少晚期妊娠并发症以及使用后的药物不良反应的影响。许多研究表明，与对照组相比，接受LMWH治疗的女性活产率有所提高，而一些研究则显示没有改善。在减少晚期妊娠并发症方面，如子痫前期、胎儿生长受限、早产和低出生体重，研究组和对照组均无统计学上的显著差异。接受LMWH治疗的女性中药物不良反应罕见，如有发生也较轻微且为自限性，因此LMWH是一种安全的治疗方法。需要开展更多研究，最好是大型多中心随机对照试验，以建立关于URPL治疗的共识指南。
