Management of Recurrent Pregnancy Loss Associated with Antiphospholipid Syndrome: A Systematic Review

Abstract

Introduction: Antiphospholipid syndrome (APS) is a significant cause of recurrent pregnancy loss (RPL). The standard treatment is a combination of aspirin and heparin. This review evaluates the efficacy of this and other treatment regimens.

Methods: A systematic search of RCTs was performed. We included studies evaluating interventions (e.g., aspirin, heparin, corticosteroids, IVIG) in women with a history of RPL and a diagnosis of APS. The primary outcome was the live birth rate.

Results: The meta-analysis confirmed that the combination of low-dose aspirin plus prophylactic heparin was significantly more effective than aspirin alone or placebo in increasing the live birth rate in women with APS. There was no evidence to support the addition of corticosteroids or IVIG.

Discussion: The antithrombotic and potential anti-inflammatory effects of aspirin and heparin are crucial for maintaining placental function in APS pregnancies. This combination therapy has become the established standard of care.

Conclusion: Combination therapy with low-dose aspirin and heparin is the most effective treatment for improving live birth rates in women with recurrent pregnancy loss due to antiphospholipid syndrome.