NEW YORK (Reuters) -- A woman in her first pregnancy died after being treated with blood-thinning drugs designed to prevent miscarriage, federal health officials reported Thursday. The 38-year-old was 9 weeks pregnant with triplets, the result of an in vitro-fertilization (IVF), when she died of a brain hemorrhage, according to the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia.
The CDC notes that while they cannot say for sure that anticoagulant therapy was the cause of death in this woman, they warn that "...the potential for bleeding associated with aspirin and heparin warrants vigorous scientific investigation and debate before it is recommended for routine use among (IVF) patients." A study is now under way to shed light on the safety and efficacy of this treatment in IVF patients.
In addition to heparin and aspirin -- two drugs that reduce blood clotting and increase the risk of bleeding -- the woman was also receiving immunoglobulin at the time of her death, although it's still not clear if the drugs contributed to her death. After she complained of a severe headache and anxiety, she lost consciousness. Physicians found and removed a malformed blood vessel in her brain. Unfortunately, she developed brain swelling and did not recover.
"Treatment of IVF patients with immunotherapy (anticoagulation or immunoglobulin) is aimed at preventing early pregnancy loss," the CDC reports in the May 15th Morbidity and Mortality Weekly Report. "Heparin and aspirin therapy substantially reduces the risk for recurrent spontaneous abortion (more than two pregnancy losses) for women with elevated antiphospholipid antibodies."
The woman who died had no history of recurrent spontaneous abortion and no antiphospholipid antibodies. CDC officials note that aspirin and heparin anticoagulation therapy is also being used to treat IVF patients in general, even though it's not clear how effective the treatment is for these women, and the use of heparin alone or in combination with aspirin has not been approved by the US Food and Drug Administration for that purpose.
SOURCE: Morbidity and Mortality Weekly Report (1998;47:368-370)
