title: Low dose aspirin and low-molecular-weight heparin in the treatment of pregnant Libyan women with recurrent miscarriage.
abstract: BACKGROUND
  Recurrent miscarriage is a major women's health problem. Aspirin and heparin have been shown to have potentially beneficial effects on trophoblast implantation. However, few published data on this issue are available from developing countries.
  
  
  METHODS
  An open clinical trial was conducted at the Department of Obstetrics and Gynecology at Misurata Teaching Hospital in Libya from January 2009 to December 2010 to investigate the effects of treatment with low dose aspirin (LDA) versus treatment with low-molecular-weight-heparin (LMWH) in combination with LDA on patients with a history of recurrent miscarriages. A total of 150 women were enrolled in the study. Women were eligible for the study if they had a history of three or more consecutive miscarriages. Participants were randomly assigned to receive either LDA (75 mg daily) alone or a combination of LDA and LMWH (75 women per treatment group). The primary outcomes were the rate of miscarriages and live births for each group.
  
  
  RESULTS
  Compared with the group who received LDA alone, the combination group had a significantly lower number of miscarriages (22/75 [29%] vs. 43/75 [47%], P < 0.001) and had a significantly higher number of live births (53/75 [71%] vs. 32/75 [42%], P < 0.001). Two preterm infants in the LDA group and three in the combination group were admitted to the neonatal intensive care unit. There were no significant differences in the mean (SD) birth weights of neonates born in either group (2955.4 ± 560 vs. 3050 ± 540 g for the LDA and combination groups, respectively, P = 0.444). There were no congenital abnormalities detected in either group.
  
  
  CONCLUSIONS
  The combination of LDA and LMWH is better than LDA alone for the maintenance of pregnancy in patients with recurrent first trimester miscarriage.
  
  
  BACKGROUND
  NCT01917799.
authors.forename: Mohamed O
authors.initials: MO
authors.lastname: Elmahashi
authors.forename: Aisha M
authors.initials: AM
authors.lastname: Elbareg
authors.forename: Fathi M
authors.initials: FM
authors.lastname: Essadi
authors.forename: Bashur M
authors.initials: BM
authors.lastname: Ashur
authors.affiliation: Department of Obstetrics and Gynecology, University of Khartoum, Khartoum, Sudan. ishagadam@hotmail.com.
authors.forename: Ishag
authors.initials: I
authors.lastname: Adam
mesh_terms: D000026:Abortion, Habitual / Q000097:blood / Q000517:prevention & control*; D000328:Adult; D001241:Aspirin / Q000008:administration & dosage* / Q000494:pharmacology; D001724:Birth Weight; D010064:Embryo Implantation / Q000187:drug effects*; D017984:Enoxaparin / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D005343:Fibrinolytic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D008002:Libya; D011225:Pre-Eclampsia / Q000097:blood; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood / Q000188:drug therapy*; D011256:Pregnancy Outcome; D044062:Prostaglandins I / Q000097:blood; D019851:Thrombophilia / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D013928:Thromboxane A2 / Q000097:blood; D014327:Trophoblasts / Q000187:drug effects; D014664:Vasodilation / Q000187:drug effects; D055815:Young Adult
chemical_list: D017984:Enoxaparin; D005343:Fibrinolytic Agents; D044062:Prostaglandins I; D013928:Thromboxane A2; D001241:Aspirin