跳至主要内容

Effectiveness of Bemiparin Sodium for Preventing Pregnancy Loss in Patients with MTHFR C677T Mutation and Habitual Abortus

Read full paper at:
http://www.scirp.org/journal/PaperInformation.aspx?PaperID=51197#.VFspxmfHRK0

Objective: In this study the purpose is to evaluate the effectiveness of daily bemiparin sodium injection in preventing early pregnancy loss and in achieving live births in pregnant patients, not ahead of 6th week, who are diagnosed with habitual abortion in a case-controlled randomized prospective study. Study Design: In this prospective study, 120 pregnant patients not ahead of 6th week and aged between 21 - 36 and diagnosed with habitual abortion between April 2011 and April 2012 in our clinic were included. Habitual abortion diagnosis criteria was based on patient history of three or more miscarriages before the 20th week and a genetically documented homozygote or heterozygote mutation of the methylenetetrahydrofolate Reductase gene. Results: The rate and the number of live births in the study group was 60 (93.75%) and statistically higher than the control group 32 (57.14%). The difference was found to be statistically significant (p = 0.001). The rate and the number of abortions in the control group was 24 (42.85%) and statistically higher than the study group 4 (6.25%). The difference was found to be statistically significant (p = 0.001). Conclusion: In order to maintain a healthy pregnancy an effective uteroplacental circulation is a must and any defects in haemostasis mechanisms may have an adverse influence. A few non-randomized studies comparing pregnancy results of low dose salycilic acid and low molecular weight heparin usage in patients also show that prophylaxis might be beneficial.
Cite this paper
Guven, D. , Bakay, K. , Kocak, I. and Ozdemir, A. (2014) Effectiveness of Bemiparin Sodium for Preventing Pregnancy Loss in Patients with MTHFR C677T Mutation and Habitual Abortus. Open Journal of Obstetrics and Gynecology, 4, 930-934. doi: 10.4236/ojog.2014.415131
 

[1] Alatas, E. (2004) Tekrarlayan gebelik kayiplarinda tani ve tedavinin yonlendirilmesi. TJD Uzmanlik Sonrasi Egitim Dergisi, 6, 19-25.
[2] Tepeli, E., Müslümanoglu, H.M. and Uludag, A. (2007) Eskigehir ilinde idiyopatik tekrarlayan gebelik kayiplari ile metilentetrahidrofolat redüktaz (MTHFR) C677T ve A1298C polimorfizmleri arasindaki iligki. Osmangazi Tip Dergisi, 29, 1-11.
[3] Oral, D., Alp, M.N. and Budak, T. (2006) Ailesel Resiprokal Translokasyon Olgusu ve Tekrarlayan Düsükler. Dicle Tip Dergisi, 33, 182-184.
[4] Balci, A., Yirmibes, M. and Bal, F. (1996) Ailesel Resiprokal Translokasyon Olgusu ve Tekrarlayan Düsükler. Perinatoloji Dergisi, 4, 218-219.
[5] Goyette, P., Sumner, J.S., Milos, R., Duncan, A.M., Rosenblatt, D.S., Matthews, R.G. and Rozen, R. (1994) Human Methylenetetrahydrofolate Reductase: Isolation of cDNA, Mapping and Mutation Identification. Nature Genetics, 7, 195-200. http://dx.doi.org/10.1038/ng0694-195
[6] Ueland, P., Refsum, H., Stabler, S., et al. (1993) Total Homocysteine in Plasma or Serum: Methods and Clinical Applications. Clinical Chemistry, 39, 1764-1779.
[7] Ray, J.G. and Laskin, C.A. (1999) Folic Acid and Homocyst(e)ine Metabolic Defects and the Risk of Placental Abruption, Pre-Eclampsia and Spontaneous Pregnancy Loss. Placenta, 20, 519-529.
http://dx.doi.org/10.1053/plac.1999.0417
[8] Lissak, A., Sharon, A., Fruchter, O., et al. (1999) Polymorphism for Mutation of Cytosine to Thymine at Location 677 in the Methylenetetrahydrofolate Reductase Gene Is Associated with Recurrent Early Fetal Loss. American Journal of Obstetrics & Gynecology, 181, 126-130.
http://dx.doi.org/10.1016/S0002-9378(99)70447-3
[9] Garcia, D.A., Baglin, T.P., Weitz, J.I. and Samama, M.M. (2012) Parenteral Anticoagulants Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 141, e24S-e43S.
[10] Sanson, B., Lensing, A., Prins, M., et al. (1999) Safety of Low-Molecularweight Heparin in 82 Pregnancy. Thrombosis and Haemostasis, 81, 668-672.
[11] Gris, J., Neveu, S., Tailland, M., et al. (1995) Use of Low-Molecular Weight Heparin (Enoxaparin) or of a Phenformin-Like Substance (Moroxydine Chloride) in Primary Early Recurrent Aborters with an ?mpaired Fibrinolyitic Capacity. Thrombosis and Haemostasis, 73, 362-367.
[12] Brenner, B., Hoffman, R., Blumenfeld, Z., et al. (2000) Gestational Outcome in Thrombophilic Women with Recurrent Pregnancy Loss Treated by Enoxaparin. Thrombosis and Haemostasis, 83, 693-697.
[13] Preston, F.E., Rosendaal, F.R., Walker, I.D., Briet, E., Berntorp, E., Conrad, J., et al. (1996) Increased Fetal Loss in Women with Heritable Thrombophilia. The Lancet, 348, 913-916.
http://dx.doi.org/10.1016/S0140-6736(96)04125-6
[14] Brigden, M.L. (1997) The Hypercoagulable State, Who, How and When to Test and Treatment. Postgraduate Medicine, 101, 5249-5268. http://dx.doi.org/10.3810/pgm.1997.05.252
[15] Dendrinos, S., Makrakis, E., Botsis, D., Chassiakos, D., Baka, S., Creatsas, G., et al. (2005) A Study of Pregnancy Loss in 352 Women with Recurrent Miscarriages. Archives of Gynecology and Obstetrics, 271, 253-259. http://dx.doi.org/10.1007/s00404-004-0607-0
[16] Li, T.-C., Iqbal, T., Anstie, B., et al. (2002) An Analysis of the Pattern of Pregnancy Loss in Women with Recurrent Miscarriage. Fertility and Sterility, 78, 1100-1106.
http://dx.doi.org/10.1016/S0015-0282(02)04207-3
[17] Paidas, M.J., Ku, D.H., Arkel, Y.S., et al. (2004) Screening and Management of Inherited Thrombophilias in the Setting of Adverse Pregnancy Outcome. Clinics in Perinatology, 31, 783-805.
http://dx.doi.org/10.1016/j.clp.2004.07.002
[18] Gris, J.C., Mercier, E., Quere, I., Lavigne-Lissalde, G., Cochery-Nouvellon, E., Hoffet, M., et al. (2004) Low Molecular Weight Heparin versus Low-Dose Aspirin in Women with One Fetal Loss and a Constitutional Thrombophilic Disorder. Blood, 103, 3695-3699. http://dx.doi.org/10.1182/blood-2003-12-4250
[19] Sharif, K.W. and Ghunaim, S. (2010) Management of 273 Cases of Recurrent ?mplantation Failure: Results of a Combined Evidence-Based Protocol. Reproductive BioMedicine Online, 21, 373-380. http://dx.doi.org/10.1016/j.rbmo.2010.03.028
[20] Alalaf, S. (2012) Bemiparin versus Low Dose Aspirin for Management of Early Pregnancy Loss Due to Antiphospholipid Antibody Syndrome. Archives of Gynecology and Obstetrics, 285, 641-647. http://dx.doi.org/10.1007/s00404-011-2055-y                                     eww141106lx

评论

此博客中的热门博文

Does Immigration Promote the Investment of the Monopolistic Firm?

In the present paper, we examine the effect of increasing uncertainty of immigrants’ growth on the optimal timing of investment of a firm that has a monopolistic power over the labor market. It is revealed that when the uncertainty of immigrants’ growth is more than a threshold level, increasing uncertainty of immigrants’ growth accelerates the optimal timing of firms’ investment and enhances the economic growth, even if the uncertainty of immigrants’ growth is formulated by the geometric Brownian motion, which is in sharp contrast to the standard result that an increase in the uncertainty postpones the optimal timing. With an increase in the immigrants over the past ten years, workforces in the host countries have been growing significantly to the extent that the immigrants represent 70% of the increase in the workforce in Europe, and 47% in the United States as OECD indicates. In the present paper, we attempted to investigate the effect of increased uncertainty caused by the growi...

Education Policy Implementation: A Mechanism for Enhancing Primary Education Development in Zanzibar

Education is one of the fundamental rights of individuals; therefore, the government of a country needs to develop and strengthen educational policy and quality as well as to ensure that everyone has equal access to basic education. The improvement of access and quality of education in the world is becoming as an essential factor in development, whereas the basic education (primary school), is acknowledged as a foundation of the higher educational development for every country. To fulfill this goal, governments introduce several policies and procedures; however, it requires some reforms and participation from the politician, policymakers, and other stakeholders to re-examine educational policy so that it can lead to multiplication and betterment of the reforms. Educational reforms actually focus on accountability. A positive educational development and reform is very challenging and needs more effort and strategy on how to use and utilize the resources effectively as such it can achie...