Abstract
OBJECTIVE: The purpose of this study was to compare the use of low-dose aspirin alone with heparin
and low-dose aspirin in the treatment of the antiphospholipid antibody syndrome. STUDY DESIGN: A prospective, single-center trial included 50 patients who were alternately assigned
to treatment. Each patient had at least three consecutive spontaneous pregnancy losses,
positive antiphospholipid antibodies on two occasions, and a complete evaluation.
Data were compared by χ2 analysis and Fisher's exact test. RESULTS: Viable infants were delivered of 11 of 25 (44%) women treated with aspirin and 20
of 25 (80%) women treated with heparin and aspirin (p < 0.05). There were no significant differences between the low-dose aspirin and the
heparin plus low-dose aspirin groups with respect to gestational age at delivery (37.8
± 2.1 vs 37.2 ± 3.4 weeks), number of cesarean sections (18% vs 20%), or complications.
CONCLUSION: Heparin plus low-dose aspirin provides a significantly better pregnancy outcome than
low-dose aspirin alone does for antiphospholipid antibody–associated recurrent pregnancy
loss. (AM J OBSTET GYNECOL 1996;174:1584-9.)
Keywords
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References
- Recurrent pregnancy loss.in: Advances in obstetrics and gynecology. 2. Mosby–Year Book, St. Louis1995: 147-177
- Antiphospholipid antibodies and recurrent pregnancy loss.Am J Reprod Immunol. 1989; 20: 52-67
- Inhibition of heparin/antithrombin III cofactor activity by anticardiolipin antibodies: a mechanism for thrombosis.Thromb Res. 1993; 71: 103-111
- Monoclonal antibodies to heparin sulfate inhibit the formation of thrombin-antithrombin III complexes.Clin Immunol Immunopathol. 1993; 67: 264-272
- Pregnancy-associated immunological disorders.Curr Opin Immunol. 1989; 1: 1165-1172
- Annotation: antiphospholipid antibodies.Br J Haematol. 1990; 74: 1-9
- Repeated fetal losses associated with antiphospholipid antibodies: a collaborative randomized trial comparing prednisone with low-dose heparin treatment.AM J OBSTET GYNECOL. 1992; 155: 1318-1323
- Heparin therapy for pregnant women with lupus anticoagulant or anticardiolipin antibodies.Obstet Gynecol. 1990; 75: 630-634
- Ultrasonographic findings of pregnancy losses after treatment for recurrent pregnancy loss: intravenous immunoglobulin versus placebo.Fertil Steril. 1994; 61: 248-251
- Interaction of heparin with antiphospholipid antibodies (APA) from the sera of women with recurrent pregnancy loss (RPL).Am J Reprod Immunol. 1995; 33: 14-20
- Heparin and pregnancy in women with a history of repeated miscarriages.Haemostasis. 1993; 23: 202-211
- Multiples of the median: an alternate method for reporting antiphospholipid antibodies in women with recurrent pregnancy loss.Obstet Gynecol. 1994; 84: 811-815
- Bone mineral density during long-term prophylaxis with heparin in pregnancy.AM J OBSTET GYNECOL. 1994; 170: 1315-1320
- Hypertensive disorders in pregnancy.in: 19th ed. Williams' obstetrics. Appleton & Lange, Norwalk, Connecticut1993: 763-817
- Outcome of treated pregnancies in women with antiphospholipid syndrome: an update of the Utah experience.Obstet Gynecol. 1992; 80: 614-620
- Association of lupus anticoagulant with antibody against phosphatidylserine.Clin Immunol Immunopathol. 1987; 42: 63-75
- Antiphospholipid antibodies and recurrent pregnancy loss: correlation between the activated partial thromboplastin time and antibodies against phosphatidylserine and cardiolipin.AM J OBSTET GYNECOL. 1990; 163: 575-584
- Prednisone does not prevent recurrent fetal death in women with antiphospholipid antibody.AM J OBSTET GYNECOL. 1989; 160: 439-443
- Low-dose aspirin: lack of association with an increase in abruptio placenta or perinatal mortality.Obstet Gynecol. 1995; 85: 1055-1058
- Clinical implication of antiphospholipid antibodies: the Utah experience.in: Phospholipid-binding antibodies. CRC, Boca Raton, Florida1990: 355-1346
- Pregnancy outcome following ultrasound-detected fetal cardiac activity in women with a history of multiple spontaneous abortions.J Soc Gynecol Invest. 1994; 1: 138-142
Article Info
Publication History
Accepted:
October 10,
1995
Received in revised form:
October 6,
1995
Received:
July 14,
1995
Footnotes
☆From the Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center at Dallas.
☆☆Reprint requests: William H. Kutteh, MD, PhD, Division of Reproductive Immunology, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75235-9032.
★0002-9378/96 $5.00 + 0 6/1/69803
Identification
Copyright
© 1996 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
