Does Enoxaparin treatment have any effects on the placenta in women with unexplained histories of habitual abortion? A case control study

依诺肝素治疗对有不明原因习惯性流产史的妇女的胎盘有影响吗?一项病例对照研究

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作者:Ayse Zehra Ozdemir, Bulent Ayas, Adem Kocaman, Mesut Önal, Gülnur Döğenci, İdris Koçak

Background

It is very common to offer low molecular weight heparin (LMWH) medications to women with unexplained habitual abortion, to increase the livebirth rate. Although no benefit from LMWH has been clearly demonstrated, examination of the effects of enoxaparin on placental structure is lacking.

Conclusions

This study demonstrates that enoxaparin did not show any significant effect on the placental structure of cases that had histories of habitual abortion.

Methods

Forty patients who had had term pregnancies and live births but also histories of habitual abortion were recruited for this study. Placentas were sampled using a systematic random sampling method. Tissue samples were obtained, embedded and sectioned for routine histological analyses. Hematoxylin and eosin staining was used. Surface area and length estimates from placental components were evaluated by using Image J. Cell proliferation and apoptosis were also assessed via immunohistochemistry.

Objective

To assess placental structural changes in pregnancies treated with enoxaparin, compared with controls. Design and setting: Case-control study in an obstetrics and gynecology unit of a tertiary-level university hospital in Turkey.

Results

There were no significant differences between the groups regarding maternal age, abortion rate, birth weight or gestational age. Comparison of the enoxaparin and control groups showed that there were no significant differences in terms of surface area and ratios of placental components. We found that Bcl-2 was generally expressed at high levels in the enoxaparin group, while there was no difference in terms of Ki-67 between the groups. Conclusions: This study demonstrates that enoxaparin did not show any significant effect on the placental structure of cases that had histories of habitual abortion.

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