title: Comparison of the effect of aspirin and heparin with or without intravenous immunoglobulin in treatment of recurrent abortion with unknown etiology: A clinical study.
abstract: OBJECTIVE
  Abortion is the most common complication of pregnancy, defined as spontaneous expulsion of products of conception before 24 weeks of pregnancy or termination of pregnancy with a fetus weighing <500 g. The aim of this study was to compare the efficacy of intravenous immunoglobulin (IVIG) in combination regimens with aspirin and heparin versus aspirin and heparin combination alone in women with idiopathic recurrent abortion.
  
  
  METHODS
  This randomized, clinical trial was performed at Imam Khomeini Hospital in Sari-Iran between March 2010 and March 2013. Sixty people were randomly allocated into two groups. The control group was treated by subcutaneous enoxaparin 40 mg daily up to 24 weeks associated with aspirin 80 mg daily up to 37 weeks of gestation. The intervention group received IVIG 200 mg/kg monthly up to 24 weeks of gestation with enoxaparin and aspirin for the same therapeutic period and the same dose as the control group.
  
  
  RESULTS
  Three patients (10%) in the intervention group had abortion and 25 (90%) had live births with mean birth weight 3.5 ± 0.9 kg. Four patients (13%) in the control group had abortions, and 28 (87%) had live births with birth weight 3.4 ± 1.2 kg (P = 0.74). The difference was not statistically significant.
  
  
  CONCLUSIONS
  It seems that employing the heparin and aspirin combination therapeutic regimen is appropriate for idiopathic abortions and avoids the high cost of IVIG use and its complications.
authors.affiliation: Obstetric and Gynecologist, Fellowship of Oncology, Department of Pediatrics, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Zeinab
authors.initials: Z
authors.lastname: Nazari
authors.affiliation: Associate Professor of Allergy and Clinical Immunology, Department of Pediatrics, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Javad
authors.initials: J
authors.lastname: Ghaffari
authors.affiliation: Obstetric and Gynecologist, Fellowship of Oncology, Department of Pediatrics, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Aghdas
authors.initials: A
authors.lastname: Ebadi
keywords: Aspirin; heparin; intravenous immunoglobulin; recurrent abortion