A daily injection of low-molecular-weight heparin (LMWH) does not increase ongoing pregnancy or live-birth rates in women with unexplained recurrent pregnancy loss, according to an article in Annals of Internal Medicine. Given the burden of injections, LMWH is not recommended for preventing miscarriage.
Recurrent loss of pregnancy before 24 weeks gestation causes emotional stress to women and their families and impedes family planning. For women with recurrent pregnancy loss caused by thrombophilic disorders, LMWH injections can increase live-birth rates. However, it is unclear if these injections can also help women without thrombophilic disorders for whom recurrent pregnancy loss is unexplained.
In this randomized, controlled, open-label, multicenter trial, 449 women with at least two consecutive early miscarriages or one late miscarriage were given either multivitamin pills or multivitamins plus a daily injection of dalteparin-sodium for up to 24 weeks gestation. At 24 weeks, 86.8 percent of pregnancies in the intervention group and 87.9 percent of pregnancies in the control group were intact. The live-birth rates were nearly identical in both groups, as well. These results suggest that LMWH does not increase ongoing pregnancy or live-birth rates in women with unexplained recurrent pregnancy loss.
Low-Molecular-Weight Heparin for Women With Unexplained Recurrent Pregnancy Loss, Annals of Internal Medicine, doi: 10.7326/P15-9014, published 4 May 2015.
Low-Molecular-Weight Heparin for Women With Unexplained Recurrent Pregnancy Loss: A Multicenter Trial With a Minimization Randomization Scheme, E. Schleussner, G. Kamin, G. Seliger, N. Rogenhofer, S. Ebner, B. Toth, M. Schenk, M. Henes, M.K. Bohlmann, T. Fischer, O. Brosteanu, R. Bauersachs, and D. Petroff, for the ETHIG II Group, Annals of Internal Medicine, doi: 10.7326/M14-2062, published 4 May 2015.