ObjectiveTo investigate the effect of anticoagulant treatment on pregnancy outcomes in
patients with previous recurrent miscarriages (RM) who carry a
methylenetetrahydrofolate reductase (MTHFR) gene
mutation.MethodsIn this longitudinal retrospective study, patients with RM were treated
during pregnancy with either: (i) 100 mg/day aspirin and 5 mg/day folic acid
(group 1); or the same protocol plus 0.4 mg/day enoxaparin (group 2). An
age-matched group of triparous women without RM or thrombophilia was used as
the control group (group 3).ResultsThis study enrolled 246 women with RM (123 per treatment group) and
age-matched controls (n = 117). The delivery rate was
significantly lower in group 1 than group 2 (46.3% versus 79.7%,
respectively). The miscarriage rate was significantly lower in group 2
compared with group 1 (20.3% versus 51.2%, respectively). In the control
group 3, the delivery rate was 86.3% and the miscarriage rate was 12.8%.ConclusionTreatment with low-dose aspirin, enoxaparin and folic acid was the most
effective therapy in women with RM who carried a C677T
MTHFR mutation.
Age younger than 25 year at the time of loop electrosurgical excision procedure is associated with a more frequent occurrence of preterm labor before 26 weeks of amenorrhea.
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