Evaluation the efficacy of aspirin and low molecular weight heparin in patients with unexplained intrauterine growth restriction accompanied by early onset oligohydramnios

الملخص EN

The roles of inflammatory cytokines and local placental thrombosis in patient with unexplained intrauterine growth restriction ( IUGR ) accompanied by early onset oligohydramnios have been shown.

Since low molecular weight heparin ( LMWH ) and aspirin have both anti-inflammatory and anti-coagulant effect, we evaluated their efficacy in patient with unexplained IUGR accompanied by early onset oligohydramnios.

Methods: A prospective comparative study that conduct at the department of obstetrics and gynecology at bint AL huda teaching hospital in Thiqar city between the 1st of march 2012 to the 1st of march 2013 in which ( 80 ) patients aged between ( 20 – 37 ) years old with unexplained IUGR and oligohydramnios referring to participated in our study, patients were divided into two groups, the thromboprophylaxis group ( n=40 ) who received aspirin ( 80 mg PO daily ) and LMWH enoxaparin ( 40 mg SQ once daily ), the other group ( n=40 ) was the control group who received no treatment apart from the usual protocol that are used for management of IUGR and oligohydramnios which involve frequent follow up.

Live birth rate, obstetrical complications, prenatal complications and hemorrhagic side effect were recorded.

Result: There was no significance difference regarding the age, parity, BMI, gestational age at time of involvement in both groups.

The rate of successful pregnancy was ( 75% ) and ( 37.5% ) in the treatment and control group respectively.

So the thromboprophylaxis group had a higher rate of live birth than control group ( P < 0.05 ).

In thromboprophylaxis group ( 12.5% ) patients and in the control group ( 37.5% ) patients had intrauterine fetal death during the period of follow up.

There were no significant difference in the number of preterm deliveries between the two groups, no maternal or fetal side effect was seen.

Conclusion: Aspirin and LMWH are successful in treatment of IUGR accompanied by early onset oligohydramnios by increasing the rate of live birth with few side effects for both the mother and fetus.