Recurrent miscarriage is distressing, affecting 1% of all women and in a significant proportion no cause can be identified. Aspirin is recommended for abortion prevention and is often used empirically. The aim of this review was to determine if the empirical use of anticoagulants in women with unexplained recurrent miscarriage is justified.
Data sources included MEDLINE, DARE and the COCHRANE databases plus the reference lists of eligible studies.
Two randomised controlled trials and two prospective cohort studies of low-dose aspirin or enoxaparin compared with placebo/no treatment administered to pregnant women with history of unexplained recurrent miscarriage with a primary outcome measure of live birth rate were selected.
The results revealed 0.81 of participants on 20μg enoxaparin and 0.82 of participants on 40μg enoxaparin had live births while 0.70 of participants on 50mg aspirin, 0.68 on 75mg aspirin and 0.84 on 100mg aspirin had live births. The control groups had proportion with live births of 0.48 (questionable methodology), 0.70 and 0.64.
There is therefore a good chance of live birth with supportive care alone and the addition of anticoagulation may be unnecessary. More research in this area is needed.
I can't paste the whole study obviously, but I will be willing to answer any questions about my findings.