Low molecular weight heparin to achieve live birth following unexplained pregnancy loss: a systematic review.

Journal of Thrombosis and Haemostasis : JTH
S ManthaJ I Zwicker

Abstract

The management of recurrent pregnancy loss is uncertain. Some cohort studies have identified an association between inherited thrombophilias and recurrent or late non-recurrent pregnancy loss, which has prompted investigators to evaluate the benefit of low molecular weight heparin (LWMH) to achieve live birth. A similar benefit for LMWH has also been proposed independent of thrombophilia status. We conducted a systematic review of randomized controlled trials to assess the benefit of LMWH in achieving live birth for women with a history of recurrent or late non-recurrent pregnancy loss in the absence of antiphospholipid antibodies. For the five studies that satisfied the eligibility criteria, the risk ratio of live birth for women with a history of pregnancy loss treated with LWMH compared with control ranged from 0.95 to 3.00. There was considerable heterogeneity among studies in terms of treatment effect (Q-value was 41.7, P=0.000, and I2=90.4%) independent of thrombophilia status. There was also a wide variation among all studies in terms of definition of early or late pregnancy loss, thrombophilic risk factors, and number of prior pregnancy losses. There is a trend for increased live births when using LWMH for the preventio...Continue Reading

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Citations

Jan 26, 2011·Thrombosis Research·Scott M Nelson
Jan 13, 2012·Genetics in Medicine : Official Journal of the American College of Medical Genetics·Linda A BradleyJoan A Scott
Aug 21, 2010·Current Opinion in Obstetrics & Gynecology·Ai-Wei Tang, Siobhan Quenby
Jan 25, 2014·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·M S KutukM Tas
Jun 7, 2011·Journal of Reproductive Immunology·Michael K Bohlmann
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Dec 7, 2010·Fertility and Sterility·Luc de Saint MartinElisabeth Pasquier
Jan 24, 2014·Thrombosis·Elisabeth M BattinelliJean M Connors
Mar 18, 2015·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Yuan ZhangMei Zhong
Dec 25, 2012·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Mirjana KovacDragica Radojkovic
Mar 3, 2012·American Journal of Reproductive Immunology : AJRI·Leif MatthiesenSurendra Sharma
Nov 5, 2010·Current Opinion in Obstetrics & Gynecology

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