Comparison of Two Therapeutic Protocols: Heparin with Aspirin VS Prednisolone with Aspirin, in Patients with Recurrent Miscarriages

Background and The most common complication of pregnancy is abortion. The etiology of recurrent pregnancy loss is not completely known. There are few therapeutics and diagnostic strategies in recurrent abortion. The aim of this study was to compare the use of heparin with aspirin vs prednisolone with aspirin in patients with recurrent pregnancy loss (RPL). This randomized clinical trial study comprised of 50 patients with RPL referred to Fatemieh Hospital, Hamadan. These patients were selected when β-HCG test was positive and were divided into two groups (n=25 for each group). Patients in the first group received subcutaneous heparin (5000 U twice a day) and oral microcoated aspirin (80 mg once a day) up to 20th week of pregnancy. Ultrasonography was repeated 3 times for these patients. Ca tablet was administrated in order to prevent osteoporosis. Antiphospholipid and anticardiolipin antibodies were checked for all patients. Neonates were visited by a neonatologist and followed up for one month. Finally, the data were analyzed by t-test and Fisher’s exact test. The mean age of prednisolone with aspirin group were 31.8±3.3 years while, it was 30.7±3.2 years in heparin with aspirin group and, this difference was not significant (P>0.05). The mean pregnancy loss number was 2.8±1.1 while 2.4±1 in prednisolone with aspirin and heparin with aspirin groups respectively, which was not statistically significant (P>0.05). Anticardiolipin antibody was positive in 4 (8%) patients, and antiphospholipid antibody was also positive in 4(8%) patients. Pregnancy loss with heparin+aspirin was significantly higher than prednisolone+aspirin (P<0.05). There was not any case of complications in two groups. The results of this study showed that prednisolone with aspirin are more effective than heparin with aspirin in the management of recurrent pregnancy loss and are preferred to use in these patients.