Anticoagulant Therapy in Primary and Secondary Recurrent Pregnancy Losses with Hereditary Thrombophilia and Perinatal Outcomes

Objective: To investigate the effect of anticoagulant treat­ment and perinatal outcomes in patients with primary or secondary recurrent pregnancy loss without cause other than inherited trombophilia. Methods: A total of 143 pregnant patients with recurrent pregnancy loss (≥2 abortus) and had no detected cause other than thrombophilia, were included in the study. Pa­tients with no livebirth history were accepted as primary and patients with at least one livebirth were as second­ary recurrent spontaneous aborters (PrimRSAs and Se­cRSAs). Inherited thrombophilia genetic results of the patients in both groups were compared. The effects of low-molecular weight heparin (LMWH) and low-dose as­pirin (LDA) treatments alone or together, livebirth rates and pregnancy outcomes were investigated. Results: Sixty-eight patients were in PrimRSAs and 75 were in SecRSAs. Ages, numbers of total, early and late pregnancy loss of both groups were similar. In PrimRSAs 49 (72.1%) and in SecRSAs 50 (66.6%) patients had three or more inherited thrombophilia genetic mutations. Of 113 patients who used LMWH+LDA during pregnancy 88 (77.6%) had livebirth; however, of 19 patients who used LMWH 6 (31.6%) and of 11 women who used LDA 8 (72.7%) had livebirth. Livebirth rate was significantly high­er in patients who used LMWH+LDA together (p=0.001). Livebirth rates were higher in SecRSAs than PrimRSAs irrespective to the anticoagulant treatment (p=0.002). Conclusion: LMWH and LDA treatment together may in­crease livebirth rates in patients with recurrent pregnancy loss and inherited thrombophilia. Having at least one live­birth of the patients is a good prognostic factor.