title: Antithrombotic treatment for recurrent pregnancy loss?
abstract: BACKGROUND
  Recurrent pregnancy loss (RPL) is a major issue for women's health. Acquired and heritable thrombophilias are associated with RPL, this association could reflect a general prothrombotic phenotype rather than a specific thrombophilia. Antithrombotic intervention has therefore been assessed for RPL.
  
  
  RESULTS
  Two large randomised trials with untreated control groups showed no benefit from antithrombotic treatment with LMWH and low dose aspirin in women with RPL. These trials had insufficient power to exclude an effect in women with underlying thrombophilia, ≥ 3 losses, or late losses.
  
  
  CONCLUSIONS
  Antithrombotic intervention should not be recommended for unexplained RPL in general. There may be specific groups such as those with an heritable thrombophilia, or with three or more losses, or second trimester losses that might benefit and where further trials are required. Further there is a need to consider the benefits of LMWH on implantation such as in women undergoing assisted conception therapy.
authors.affiliation: Faculty of Health & Life Sciences, University of Liverpool, Liverpool, UK. ian.greer@liverpool.ac.uk
authors.forename: I A
authors.initials: IA
authors.lastname: Greer
mesh_terms: D000026:Abortion, Habitual / Q000517:prevention & control*; D000328:Adult; D000991:Antithrombins / Q000627:therapeutic use*; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic
chemical_list: D000991:Antithrombins; D006495:Heparin, Low-Molecular-Weight