Evaluation of thromboprophylaxis in bad obstetric history patients with elevated antiphospholipid antibodies
Journal Title: MedPulse -International Medical Journal - Year 2015, Vol 2, Issue 5
Abstract
Objectives: To find the effect of thromboprophylaxis on pregnancy outcome in patients with elevated antiphospholipid antibody. To compare efficiency of aspirin alone and aspirin plus low molecular weight heparin (LMWH) in pregnancy outcome in patients with elevated antiphospholipid antibody. Methods: The present study, prospective randomised control study conducted at kasturba medical college Manipal, Karnataka from nov.2000-nov.2002. During the study, patients with 2 or more consecutive abortions, 1 or more intrauterine deaths and 1or more neonatal deaths were included in the study. Out of 111 patients with bad obstetric history who underwent anticardiolipin antibody assay by enzyme immune and lupus anticoagulant assay by activated partial thromboplastintime (APTT), 57 had elevated antiphospholipid antibodies. Out of these 57 patients 37 received aspirin and 20 patients received aspirin with low molecular weight heparin. Results: Elevated antiphospholipid antibodies were seen in 51.3% of bad obstetric history patients. Antiphospholipid were associated with 1st trimester loss in 70.2% patients 5.3% had 2nd trimester loss. Both 1st and 2nd trimester loss was seen in 3.5%, 14% IUDS and 7% had NND. The live birth rate was 65.8% with thromboprophylaxis and 6.5% without thromboprophylaxis which is statistically significant. Live birth rate with aspirin alone was 52.4% and with aspirin plus LMWH was 82.4% which is statistically significant. 56.3% live birth seen in patients with thromboprophylaxis in pre and post conception period. 72.7% live birth in patients with thromboprophylaxis in post conception period which is not statistically significant. Conclusion: Thromboprophylaxis with aspirin plus LMWH leads to significant higher rate of live births than aspirin alone.
Authors and Affiliations
Anjanadevi Santpure, Prasad Bhanap
Keywords
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