Obstetrics and Gynecology
Malihe Afiat; Nayere Khadem; Behnaz Ansari; Fedyeh Haghollahi; Mohadese Dashtkoohi; Mohammad Sadeq Najafi; Mohammad Dashtkoohi; MirFarbod Hojati Bagheri; Seyede Houra Mousavi Vahed
Articles in Press, Accepted Manuscript, Available Online from 05 February 2024
Abstract
Background and Objective: The effectiveness of aspirin and heparin in improving live birth rates in unexplained recurrent pregnancy loss remains uncertain, and further research is needed on using low molecular weight heparins (LMWH) through randomized clinical trials. This study aims to assess the impact ...
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Background and Objective: The effectiveness of aspirin and heparin in improving live birth rates in unexplained recurrent pregnancy loss remains uncertain, and further research is needed on using low molecular weight heparins (LMWH) through randomized clinical trials. This study aims to assess the impact of enoxaparin, an LMWH, and its outcomes in women with URPL.
Methods: This study presents a single-blinded randomized clinical trial involving 80 women with URPL and no history of thrombophilia. The participants were referred to the Infertility Clinic at Imam Reza Hospital (Milad Center) between March 2018 and February 2019. During the sixth week of gestation, the participants were assigned randomly to two groups. The treatment group (n = 40) received a daily subcutaneous injection of 40 mg of enoxaparin, while the control group (n = 40) received routine pregnancy care. Maternal and neonatal demographic data, pregnancy outcomes, complications, and live birth rates were recorded and subsequently compared between the two groups.
Results: A total of 80 eligible women were enrolled in the study, with equal distribution between the treatment and control groups. There were no significant differences in previous pregnancies or miscarriages between the groups, and the live birth rate was about 85% in both groups. The occurrence of pregnancy complications was significantly higher in the treatment group compared to the control group (38.2% VS. 5.7%; p = 0.021).
Conclusion: Treatment with enoxaparin in women with unexplained recurrent pregnancy loss and no history of thrombophilia did not improve the pregnancy outcome nor decrease pregnancy complications.
Maternal Fetal Medicine
Maryam Nurzadeh; Maryam Moshfeghi; Mamak Shariat; Ashraf Sadat Jamal; Vajiheh Marsoosi; Laleh Eslamian; Mahsa Naemi; Maria Nezam Nia; Fedyeh Haghollahi; Seyede Houra Mousavi Vahed
Volume 8, Issue 4 , July and August 2023, , Pages 335-341
Abstract
Background & Objective: A number of procedures have been developed for multifetal pregnancy reduction (MPR) to reduce the overall number of fetuses in the gestation and improve the maternal outcomes as well as the outcomes of the surviving fetus.Materials & Methods: An observational ...
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Background & Objective: A number of procedures have been developed for multifetal pregnancy reduction (MPR) to reduce the overall number of fetuses in the gestation and improve the maternal outcomes as well as the outcomes of the surviving fetus.Materials & Methods: An observational historical cohort study was conducted on multiple pregnancies that underwent fetal reduction in Shariati Hospital and Omid Clinic between January 2018 and September 2021. The study population was divided into two groups according to gestational age at fetal reduction: 11–14 weeks' gestation (early reduction group) and 15–19 weeks’ gestation (late reduction group). The main outcome measures were the rates of pregnancy complications, pregnancy loss, preterm delivery, and adverse neonatal outcomes.Results: The study group included 107 patients with twin and multiple pregnancies that underwent abdominal MPR at 11-19 weeks’ gestation (79 in the early reduction group and 28 in the late group). The incidence of pregnancy complications (hypertension, diabetes, intrauterine growth disorder, preterm delivery, and pregnancy loss) was not significantly different between the two groups (P >0.05). The percentage of NICU admission was higher in the early reduction group compared to the late group (49% vs 18.5%, P=0.004). The weight of the first newborn was significantly heavier in the late versus early reduction group (2680.55±777.52 vs 2264.4±796.82, P=0.005).Conclusion: According to the present study, fetal reduction in twin or multiple pregnancies is a safe procedure with good obstetric outcomes if done by an expert specialist, especially when it is performed in the second trimester.
