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Three Anticoagulant Studies May Change Current Medical Practice Including New Data Revealing That Preventative Use of Aspirin and Heparin is Not Effective in Reducing Recurrent, Unexplained Miscarriages
Date:12/6/2009

ses, women with previous venous or arterial thromboembolism (clotting disorders), endocrine disorders, or other indications for anticoagulant treatment during pregnancy were excluded from the study.

"The study clearly demonstrates that aspirin combined with heparin and aspirin alone do not prevent recurrent, unexplained miscarriages and that we should not needlessly put these women through the inconvenience and risks associated with these blood-thinning medications," said lead study author Stef P. Kaandorp, MD, research fellow in the Department of Obstetrics and Gynecology at the Academic Medical Center in Amsterdam. "These results are extremely important because they will likely change the way some women at high risk for another miscarriage have been treated."

During the study, three treatment groups were compared: aspirin and nadroparin (a low-molecular-weight heparin), aspirin alone, and placebo. Oral medication was administered once a day beginning on the day of inclusion in the study through 36 weeks of gestational age, or until miscarriage, ectopic pregnancy, or premature delivery. Patients on the oral regimens received either placebo pills or 100 mg of calcium carbasalate (a salt formulation of aspirin equivalent to 80 mg of aspirin). Women who were to receive low-molecular-weight heparin received subcutaneous injections once a day of 2,850 international units of nadroparin from six weeks of gestational age through 12 hours before delivery.

The intention-to-treat analysis of the study showed that the live birth rate did not differ significantly among the three treatment groups: 54.5 percent of those in the aspirin and nadroparin group had a live birth (67 women), compared with 50.8 percent in the aspirin group (61 women), and 57 percent of the placebo group (69 women). Side effects, most notably skin reactions, also occurred more often in women assigned to the aspirin and nadroparin group.

Dr. Kaandorp will pre
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SOURCE American Society of Hematology
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