Antiphospholipid antibody-associated recurrent pregnancy loss: Treatment with heparin and low-dose aspirin is superior to low-dose aspirin alone

被引:589
作者
Kutteh, WH
机构
[1] Division of Reproductive Immunology, Department of Obstetrics/Gynecology, University of Texas SW Medical Ctr., Dallas, TX 75235-9032
关键词
recurrent pregnancy loss; antiphospholipid antibodies; heparin; low-dose aspirin;
D O I
10.1016/S0002-9378(96)70610-5
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
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 chi(2) 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.
引用
收藏
页码:1584 / 1589
页数:6
相关论文
共 21 条
[1]   ASSOCIATION OF LUPUS ANTICOAGULANT WITH ANTIBODY AGAINST PHOSPHATIDYLSERINE [J].
BRANCH, DW ;
ROTE, NS ;
DOSTAL, DA ;
SCOTT, JR .
CLINICAL IMMUNOLOGY AND IMMUNOPATHOLOGY, 1987, 42 (01) :63-75
[2]  
BRANCH DW, 1992, OBSTET GYNECOL, V80, P614
[3]  
BRANCH DW, 1990, PHOSPHOLIPID BINDING, P355
[4]   INHIBITION OF HEPARIN ANTITHROMBIN-III COFACTOR ACTIVITY BY ANTICARDIOLIPIN ANTIBODIES - A MECHANISM FOR THROMBOSIS [J].
CHAMLEY, LW ;
MCKAY, FJ ;
PATTISON, NS .
THROMBOSIS RESEARCH, 1993, 71 (02) :103-111
[5]  
COULAM CB, 1994, FERTIL STERIL, V61, P248
[6]   REPEATED FETAL LOSSES ASSOCIATED WITH ANTIPHOSPHOLIPID ANTIBODIES - A COLLABORATIVE RANDOMIZED TRIAL COMPARING PREDNISONE WITH LOW-DOSE HEPARIN TREATMENT [J].
COWCHOCK, FS ;
REECE, EA ;
BALABAN, D ;
BRANCH, DW ;
PLOUFFE, L .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1992, 166 (05) :1318-1323
[7]  
Cunningham FG., 1993, WILLIAMS OBSTET, V19th ed, P763
[8]  
DAHLMAN TC, 1994, AM J OBSTET GYNECOL, V170, P1315
[9]   INTERACTION OF HEPARIN WITH ANTIPHOSPHOLIPID ANTIBODIES (APA) FROM THE SERA OF WOMEN WITH RECURRENT PREGNANCY LOSS (RPL) [J].
ERMEL, LD ;
MARSHBURN, PB ;
KUTTEH, WH .
AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, 1995, 33 (01) :14-20
[10]  
HARRIS EN, 1990, BRIT J HAEMATOL, V74, P1, DOI 10.1111/j.1365-2141.1990.tb02530.x