New research has found that a drug commonly prescribed to pregnant women with an inherited blood clotting disorder and a history of recurrent miscarriage does not help reduce their risk of miscarriage.
Researchers are recommending that doctors stop offering the blood thinner low-molecular-weight heparin (heparin) to patients with hereditary thrombophilia.
The condition causes the blood to have a greater tendency to form clots in the veins and arteries.
Stopping screening for hereditary thrombophilia and ending the use of heparin as a treatment for these patients could save the NHS around £20 million a year, the researchers suggest.
They also argue that continuing to offer the medication offers false hope that it can be a preventative treatment.
A new study funded by the National Institute for Health and Care Research (NIHR) and published in The Lancet suggests that a daily injection of heparin does not improve the chances of a live birth for patients who have had two or more miscarriages and have confirmed inheritances. thrombophilia
It is estimated that this would affect around 50,000 couples a year in the UK.
Siobhan Quenby, professor of obstetrics at the University of Warwick, said: “Patients and clinicians will always appreciate knowing any factors that may be associated with recurrent miscarriage, but the association between hereditary thrombophilia and miscarriage recurrent miscarriage is unproven: A recent review of research showed that thrombophilia is as common in the general population as it is in patients with recurrent miscarriage.
“Worldwide, many people with recurrent miscarriage are tested for hereditary thrombophilia and treated with daily heparin.”
Ms Quenby, who is also deputy director of Tommy’s National Center for Miscarriage Research, added: “Research now shows that this screening is unnecessary, the treatment is not effective and it is giving false hope to many in continue to offer it. as a possible preventive treatment.”
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The study recruited people from 40 hospitals in the UK, the Netherlands, the US, Belgium and Slovenia.
About 326 patients with hereditary thrombophilia and recurrent miscarriage were divided into two groups: 164 received heparin throughout pregnancy, starting as soon as possible after a positive pregnancy test and ending at the onset of labor .
Meanwhile, 162 were not offered the medication.
All participants received standard obstetrician-led care and all were encouraged to take folic acid.
According to the findings, the rate of live births for each group was about the same: 116 (71.6%) treated with heparin had a baby born alive after 24 weeks of pregnancy.
And 112 (70.9%) of the standard care group had a live-born baby after 24 weeks.
The researchers also found that the risk of other pregnancy complications, such as miscarriage, low birth weight babies, placental abruption, preterm birth or preeclampsia, was about the same for two groups
As expected, 73 (45%) of people in the heparin group (mostly around injection sites) reported bruising easily, compared to only 16 (10%) in the standard care group.
More than a quarter (28%) of people who took part in the trial lost their pregnancies, and these unexplained losses will be the focus of further studies.
