title: Randomized study of subcutaneous low molecular weight heparin plus aspirin versus intravenous immunoglobulin in the treatment of recurrent fetal loss associated with antiphospholipid antibodies.
abstract: OBJECTIVE
  To compare the 2 most efficacious therapeutic regimens, intravenous immunoglobulin (IVIG) and anticoagulation with low molecular weight (LMW) heparin plus low-dose aspirin, in women with recurrent pregnancy loss associated with antiphospholipid antibodies (aPL).
  
  
  METHODS
  We examined 40 women with recurrent abortion (at least 3 occurrences) and repeatedly positive test results for anticardiolipin or lupus anticoagulant. The subjects were randomly assigned to treatment with IVIG or LMW heparin plus low-dose aspirin. Both therapies were started when the women were pregnant as documented by a positive urine test. IVIG was stopped at the thirty-first week of gestation, aspirin at the thirty-fourth week, and heparin at the thirty-seventh week. The primary outcome of interest was the rate of live births with the 2 treatments.
  
  
  RESULTS
  The characteristics of the 2 groups were similar at the time of randomization. The women treated with LMW heparin plus low-dose aspirin had a higher rate of live births (84%) than those treated with IVIG (57%).
  
  
  CONCLUSIONS
  Treatment with LMW heparin plus low-dose aspirin should be considered as the standard therapy for recurrent pregnancy loss due to aPL.
authors.affiliation: Cattedra di Reumatologia, Istituto di Clinica Medica, Policlinico and University of Palermo, Palermo, Italy. triolog@tiscalinet.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Triolo
authors.forename: Angelo
authors.initials: A
authors.lastname: Ferrante
authors.forename: Francesco
authors.initials: F
authors.lastname: Ciccia
authors.forename: Antonina
authors.initials: A
authors.lastname: Accardo-Palumbo
authors.forename: Antonino
authors.initials: A
authors.lastname: Perino
authors.forename: Antonio
authors.initials: A
authors.lastname: Castelli
authors.forename: Antonio
authors.initials: A
authors.lastname: Giarratano
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Licata
mesh_terms: D000026:Abortion, Habitual / Q000209:etiology / Q000517:prevention & control*; D000293:Adolescent; D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D016736:Antiphospholipid Syndrome / Q000150:complications / Q000188:drug therapy*; D001241:Aspirin / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D011897:Random Allocation; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D016756:Immunoglobulins, Intravenous; D001241:Aspirin