open access

Vol 88, No 5 (2017)
Research paper
Published online: 2017-05-31
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The impact of low molecular weight heparin on obstetric outcomes among unexplained recurrent miscarriages complicated with methylenetetrahydrofolate reductase gene polymorphism

Orkun Cetin1, Erbil Karaman1, Numan Cim1, Deniz Dirik1, Hanim Guler Sahin1, Erdal Kara2, Ramazan Esen2
DOI: 10.5603/GP.a2017.0049
·
Pubmed: 28580572
·
Ginekol Pol 2017;88(5):260-265.
Affiliations
  1. Department of Obstetrics and Gynecology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey, Turkey
  2. Department of Internal Medicine, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey

open access

Vol 88, No 5 (2017)
ORIGINAL PAPERS Obstetrics
Published online: 2017-05-31

Abstract

Objectives: The association between methylenetetrahydrofolate reductase gene polymorphisms and unexplained recurrent miscarriage is elusive. The recommendations for improving pregnancy outcomes in these patients keep changing based on the available evidence. The aim of this study is to analyze the impact of low molecular weight heparin on obstetric outcomes of recurrent miscarriage patients complicated with methylenetetrahydrofolate reductase gene polymorphism.

Material and methods: We reviewed medical records of 121 patients with a history of recurrent miscarriage complicated by methylenetetrahydrofolate reductase gene polymorphisms, retrospectively. From among them, 68 patients were treated only with folic acid and iron. The remaining 53 patients were treated with folic acid, iron and prophylactic doses of low molecular weight heparin. The subsequent pregnancy outcomes of these patients were noted.

Results: The live birth rate was higher in patients with anticoagulant therapy than in patients without anticoagulant therapy (48.5% vs. 69.8%, respectively, p: 0.015) and the congenital anomaly rate was lower in anticoagulant therapy group (17.6% vs. 3.8%, respectively, p: 0.022). The other obstetric outcomes were found to be similar between the two groups.

Conclusions: The current study demonstrated that low molecular weight heparin improved the live birth rates among unex­plained recurrent miscarriage patients complicated with methylenetetrahydrofolate reductase gene polymorphisms. How­ever, the routine use of low molecular weight heparin did not improve the late pregnancy complications in these selected patients in the eastern region of our country. Further studies are needed to discriminate the effect of anticoagulation on the live birth rate of each of methylenetetrahydrofolate reductase gene polymorphism type.

Abstract

Objectives: The association between methylenetetrahydrofolate reductase gene polymorphisms and unexplained recurrent miscarriage is elusive. The recommendations for improving pregnancy outcomes in these patients keep changing based on the available evidence. The aim of this study is to analyze the impact of low molecular weight heparin on obstetric outcomes of recurrent miscarriage patients complicated with methylenetetrahydrofolate reductase gene polymorphism.

Material and methods: We reviewed medical records of 121 patients with a history of recurrent miscarriage complicated by methylenetetrahydrofolate reductase gene polymorphisms, retrospectively. From among them, 68 patients were treated only with folic acid and iron. The remaining 53 patients were treated with folic acid, iron and prophylactic doses of low molecular weight heparin. The subsequent pregnancy outcomes of these patients were noted.

Results: The live birth rate was higher in patients with anticoagulant therapy than in patients without anticoagulant therapy (48.5% vs. 69.8%, respectively, p: 0.015) and the congenital anomaly rate was lower in anticoagulant therapy group (17.6% vs. 3.8%, respectively, p: 0.022). The other obstetric outcomes were found to be similar between the two groups.

Conclusions: The current study demonstrated that low molecular weight heparin improved the live birth rates among unex­plained recurrent miscarriage patients complicated with methylenetetrahydrofolate reductase gene polymorphisms. How­ever, the routine use of low molecular weight heparin did not improve the late pregnancy complications in these selected patients in the eastern region of our country. Further studies are needed to discriminate the effect of anticoagulation on the live birth rate of each of methylenetetrahydrofolate reductase gene polymorphism type.

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Keywords

unexplained recurrent miscarriage, methylenetetrahydrofolate reductase gene polymorphism, low molecular weight heparin, obstetric outcomes

About this article
Title

The impact of low molecular weight heparin on obstetric outcomes among unexplained recurrent miscarriages complicated with methylenetetrahydrofolate reductase gene polymorphism

Journal

Ginekologia Polska

Issue

Vol 88, No 5 (2017)

Article type

Research paper

Pages

260-265

Published online

2017-05-31

DOI

10.5603/GP.a2017.0049

Pubmed

28580572

Bibliographic record

Ginekol Pol 2017;88(5):260-265.

Keywords

unexplained recurrent miscarriage
methylenetetrahydrofolate reductase gene polymorphism
low molecular weight heparin
obstetric outcomes

Authors

Orkun Cetin
Erbil Karaman
Numan Cim
Deniz Dirik
Hanim Guler Sahin
Erdal Kara
Ramazan Esen

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