الفهرس 
R ECURRENT P REGNANCY L OSSOnly 14 pages are availabe for public view
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Abstract
Background: A small proportion of cases of recurrent pregnancy loss are associated with identifiable causes in the mother or fetus, but the underlying cause in most of cases remains unknown.
Objective: Assessment of safety and efficiency of anticoagulant therapy in treating cases of recurrent miscarriage with negative antiphospholipid antibodies.
Methods: This study was conducted on 80 women with recurrent miscarriage without diagnostic criteria of anti-phospholipid syndrome (APS). Cases were randomly enrolled and divided into two equal groups to receive one of the following treatments once fetal heart activity was detected by ultrasound; study group received low dose aspirin till 36 weeks of gestation plus low molecular weight heparin (LMWH) till the end of pregnancy and control group received low dose aspirin alone till 36 weeks of gestation. Continuation of viable pregnancy beyond 20 weeks of gestation, live birth rate, miscarriage rate occurrence of pregnancy complications and any maternal or fetal side effects of used medications were compared between both groups.
Results: there were no statistically significant differences between study groups regarding fetal and maternal outcomes as fetal viability at all visits, incidence of fetal anomalies or still birth, mode of delivery, drug-related adverse events and incidence of preterm delivery. On the other hand, the gestational age at delivery was significantly higher and the incidence of NICU admission and neonatal death were significantly lower in the aspirin plus LMWH compared with the aspirin only group.
Conclusion: Combination of aspirin and LMWH was more effective than aspirin alone in decreasing the incidence of miscarriage in the first 20 weeks of pregnancy and the incidence of postpartum NICU admission and neonatal death in women with unexplained recurrent pregnancy loss.