Serum estradiol (E2), progesterone (P), and human chorionic gonadotropin (HCG), D-dimer (D-D) fibrinogen (FIB) levels after low molecular weight heparin sodium on preventing miscarriage in patients with adverse pregnancy and delivery.

Abstract

Background: This study investigates the effects of subcutaneous injection of low molecular weight heparin (LMWH) sodium on preventing miscarriage in patients with adverse pregnancy and delivery. Specifically, it evaluates changes in serum estradiol (E2), progesterone (P), and human chorionic gonadotropin (HCG), as well as D-dimer (D-D) and fibrinogen (FIB) levels following treatment.

Methods: A total of 82 patients with adverse pregnancy admitted to Wuhai Maternal and Child Health Hospital from April to December 2024 were randomly assigned to either the control group (CG, n=41) receiving dydroges-terone therapy or the observation group (OG, n=41), which received LMWH sodium in addition to dydroges-terone. The study assessed changes in sex hormone levels, pre-thrombotic state (PTS) indices, thromboelastogram (TEG) parameters, and overall treatment outcomes before and after treatment.

Results: Following treatment, E2, P, and HCG levels were significantly higher in the OG compared to the CG (P<0.05). Additionally, coagulation markers such as activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), and plasminogen (PLG) were significantly elevated in the OG, while FIB and D-D levels were lower compared to the CG (P<0.05). TEG analysis showed that the OG exhibited higher R and K values, whereas MA, Angle, and CI values were lower than in the CG (P<0.05). The total response rate in the OG (95.12%) was significantly higher than in the CG (75.61%) (P<0.05). Additionally, the OG had lower rates of neonatal malformation, low birth weight, and mortality compared to the CG, with significant differences in malformation and low birth weight rates (P<0.05).

Conclusions: Subcutaneous injection of LMWH sodium effectively improves sex hormone levels, reduces the risk of PTS, and enhances pregnancy outcomes in patients with adverse pregnancy and delivery. The therapy also improves coagulation and fibrinolytic markers, leading to better maternal and neonatal outcomes.