Why the study?
Does the number of prior fetal losses impact live birth rates in women with thrombophilic disorders treated with enoxaparin?
Does the number of prior fetal losses impact live birth rates in women with thrombophilic disorders treated with enoxaparin?
In women with thrombophilia treated with enoxaparin, a history of ≥4 prior fetal losses is associated with a significantly lower live birth rate compared to those with 0-1 prior losses, suggesting multifactorial etiology.
≥4 prior losses identify high-risk subgroup despite enoxaparin; leaves open multifactorial etiology and need for targeted trials.
Women with thrombophilic disorders may have pregnancy complications including fetal loss (FL); however, the impact of thromboprophylaxis with low molecular weight heparin (LMWH) and previous obstetric history remains to be clarified. Our aim was to compare the effects of LMWH in three groups of women with thrombophilia who had varying numbers of prior fetal losses. We prospectively investigated the live birth rates in 66 women with thrombophilic conditions, treated with a LMWH (enoxaparin, 40 mg daily). Groups 1, 2 and 3 included patients with 0-1, 2-3 and ≥ 4 pregnancy losses, respectively. Groups 1, 2 and 3 had 90.47%, 83.78% and 50.00% live birth frequencies, respectively. Group 3 had a significantly lower chance of a live birth compared with Group 1, regardless of type of thrombophilic disorder. FL aetiology in thrombophilic patients with multiple miscarriages appears multifactorial, and thromboprophylaxis alone may not be sufficient.
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Sucak et al. (2010) studied this question.
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