Role of Low Molecular Weight Heparin in the Management of Unexplained Recurrent Pregnancy Loss: A Review of Literature

Abstract

Recurrent pregnancy loss remains a significant challenge in gynecological practice, accounting for about 2%-4% of pregnancies. In some patients, the etiology is unknown. Unexplained recurrent pregnancy loss (URPL) refers to the spontaneous loss of three or more consecutive pregnancies without an identifiable risk factor, accounting for about 40%-50% of pregnancy losses. The review aims to understand the role of low molecular weight heparin (LMWH) in the treatment of URPL. Articles for this review have been found in the PubMed database, and studies published more than ten years before the review excluded. The articles were reviewed to determine the effect of LMWH on live birth rates, reduced late pregnancy complications, and adverse drug reactions following its use. Many studies show improved live birth rates in women treated with LMWH compared to the control, while some studies show no improvement. There was no statistically significant difference in reducing late pregnancy complications, such as preeclampsia, intrauterine growth restriction, preterm labor, and low birth weight, in either study and control groups. Adverse drug reaction was rare among women treated with LMWH and, if present, was mild and self-limiting, thus making it a safe therapy. More studies, preferably large multicenter randomized controlled trials, need to be conducted on the use of LMWH to establish a consensus guideline on the treatment of URPL.

Does the use of low-molecular-weight heparin during pregnancy change the expression of PD-1 and PDL-1 in women with recurrent pregnancy loss?

“…Low-molecular-weight heparin (LMWH) has both anticoagulant and anti-inflammatory effects. It is widely used in the treatment of recurrent pregnancy loss when used alone or in combination with other agents such as acetylsalicylic acid ( 7 , 8 , 9 ) . In many studies, it has been determined that LMWH shows positive results in live births and reduces complications such as preeclampsia and preterm birth ( 10 , 11 , 12 ) .…”

Research on the Mechanism of Asperosaponin VI for Treating Recurrent Spontaneous Abortion by Bioinformatics Analysis and Experimental Validation

“…Embryonic chromosomal abnormality is the main cause of spontaneous abortion in early pregnancy, which results in over 50% of rst trimester miscarriages [6][7][8]. However, there exist approximately 50% of RSA cases with unexplained recurrent spontaneous abortion [9]. RSA seriously poses threat to the life and health of pregnant women, increasing the burden on families and society.…”

Key Gene and Functional Pathways Identified in Unexplained Recurrent Spontaneous Abortion Using Targeted RNA Sequencing and Clinical Analysis

“…Embryonic chromosomal abnormalities are a major cause of spontaneous abortion during the first trimester; multiple studies have shown that at least 50% of first trimester miscarriages are associated with embryonic chromosomal abnormalities (8)(9)(10). However, there remain 40% to 50% of patients with unexplainable miscarriage, referred to as unexplained recurrent spontaneous abortion (URSA) (11). Previous studies have suggested that RSA may be associated with uncharacteristic chromosomal microstructure, gene expression, and noncoding RNA expression variation (12)(13)(14).…”