Abstract

Background: Obstetric complications are the hallmark of antiphospholipid syndrome. Recurrent miscarriage, pre-term birth, oligohydramnios, prematurity, intrauterine growth restriction, pre-eclampsia/eclampsia, thrombosis and placental insufficiency are the most severe complications in patients of bad Obstetric history with elevated anti-phospholipid antibodies. Hence this single-center study was carried out to identify the pregnancy complications and side effects of aspirin alone and aspirin plus low molecular weight heparin (LMWH) in spite of the treatment.
Methods and Methods: This prospective, single-center study was conducted among 57 patients in the Department of Obstetrics and Gynaecology, Kasturba Medical College Hospital, Manipal, Karnataka, India during the period of November 2000 to November 2002. Recruitment of patients was done depending upon the bad obstetric history. They underwent test for anticardiolipin antibodies (ACA) and Lupus anticoagulant (LA).Out of 111 patients 57 patients were positive for anti-phospholipid antibodies (APA). They were further divided into aspirin alone group and aspirin plus low molecular heparin group randomly after confirmation of pregnancy. The complication like Intrauterine growth restriction (IUGR),pregnancy induced hypertension (PIH), oligohydramnios and preterm were studied.The data was entered and tabulated in MS-Excel 2007, and statistical analysis was performed by using Statistical Package for the Social Sciences (SPSS 22.0) version.
Results: Comparison of pregnancy complications in aspirin alone and aspirin plus low molecular weight heparin(LMWH)group showed that Intrauterine growth restriction( IUGR) was seen in 27.3% and 14.3%, Pregnancy induced hypertension( PIH) in 27.3% and 7.1% and oligohydramnios in 9% and 14.3% in aspirin alone and aspirin plus LMWH groups respectively. The results were not statistically significant. Local pain was recorded in 10(50%) of patients in LMWH group. Around 10(27%) of aspirin patients experienced an epigastric pain. No patient had bleeding disorder.
Conclusion: Over period of time not much change in pregnancy complication rate seen despite medication with aspirin alone and aspirin plus LMWH.