Effect of low-molecular-weight heparin on gestational sac and embryo development, and miscarriage prevention for recurrent spontaneous abortion.

Objective: To evaluate the efficacy of low-molecular-weight heparin (LMWH) in pregnant women with recurrent spontaneous abortion (RSA) and to investigate the correlation with changes in the gestational sac and embryo development, and miscarriage prevention as outcomes.

Methods: A retrospective analysis was conducted on 100 pregnant women with RSA treated at Hulunbeier People's Hospital between January 2022 and January 2023. Among them, 52 patients received LMWH therapy (observation group), while 48 received routine treatment (control group). Serum levels of human chorionic gonadotropin (hCG), progesterone (P), estradiol (E2), and coagulation markers (D-dimer [D-D], plasminogen activator inhibitor 1 [PAI-1], and fibrinogen), as well as gestational sac diameter (GSD), embryo length (EL), and uterine artery blood flow resistance, were assessed before and after treatment. Pregnancy outcome and adverse reaction rate were recorded and compared. Patients were categorized into successful and unsuccessful groups based on miscarriage prevention outcomes, and differences in GSD and EL were analyzed. Logistic regression was performed to identify factors influencing miscarriage prevention.

Results: Baseline hCG, P, E2, D-D, PAI-1, fibrinogen, GSD, EL, and uterine artery blood flow resistance were comparable between groups (all P>0.05). After treatment, these measuremnts improved significantly, with greater changes in the observation group (all P<0.05). The term pregnancy rate was significantly higher in the observation group than in the control group (P<0.05), while adverse reaction rates were similar (P>0.05). The successful group exhibited significantly greater GSD and EL compared to the unsuccessful group (P<0.05). Logistic regression identified age, number of miscarriages, and LMWH use as independent factors influencing miscarriage prevention outcome (P<0.05).

Conclusions: LMWH therapy significantly improves hormone levels, coagulation status, GSD, and EL in pregnant women with RSA, enhancing miscarriage prevention outcomes with minimal adverse reactions, making it a safe and effective treatment option for clinical practice.