ABSTRACT

Antithrombotic agents encompass two classes of drugs: antiplatelet agents and anticoagulant agents. Antiplatelet agents prevent platelets from aggregating and forming blood clots. This chapter explores the evidence for use of these agents in preventing recurrent pregnancy loss (RPL) in women with and without a diagnosed thrombophilia. The presence of a thrombophilia can increase the risk of multiple adverse pregnancy outcomes. The initial studies that found an association between RPL and inherited thrombophilias were small case-control studies and meta-analyses. Multiple prospective studies exist looking at the effect of anticoagulants on successful pregnancy outcome in women with RPL and no inherited thrombophilia. Many trials have been performed examining the combination of antiplatelet agent aspirin in women with RPL and without a history of inherited thrombophilia. M. Tulppala et al. originally looked at aspirin versus placebo for women with RPL and no history of thrombophilia and found no difference with aspirin treatment in live births between the groups.