Role of Low Molecular Weight Heparin (LMWH) in the Treatment of Recurrent Missed Abortion

Abstract

Introduction:Recurrent pregnancy loss (RPL) is a common and frustrating obstetric problem affecting 0.5% -5% women in different population 1,2 . Approximately 15-20% of clinically recognized pregnancies are generally subjected to spontaneous abortion, mostly during first trimester 3 . Most of these abortions are early missed abortions. Missed abortion may be either embryonic (preclinical) or fetal miscarriage. Embryonic miscarriage is defined as an embryo with crown rump length of more than or equal to 5cm without cardiac activity, fetal miscarriage is defined as a fetus of 7-20 weeks size with negative cardiac activity 4 .Genetic factors including chromosomal disorders, single gene defects, and multifactorial factors account for 3.5-5% of the causes of recurrent missed abortion 5 . There is a big volume of literature describing that cytogenetic abnormality is detected in 31% of early missed abortion 6,7 . Other studies showed that foetal chromosomal abnormalities account for about 50% of first trimester and near 30% of second trimester pregnancy losses 8,9 . Studies revealed that maternal insertional translocation associated with recurrent missed abortion 10-15 .