Role of enoxaparin on fetal loss associated with genital infection (bacterial vaginosis and cytomegalovirus)

Fetal loss is one of the most important problems of the woman’s health, which significantly affects her psychological status. It has different causes, so there is no unique method for its diagnosis and treatment.The objective: to evaluate the enoxaparin effect in pregnancy with recurrent fetal loss related to genital infections.Materials and methods: a cross-sectional study 205 included pregnant women with fetal loss in the history who were managed at Hospital from January 1st, 2022, to October31st, 2023. Serodiagnosis of IgG and IgM against cytomegalovirus (CMV) was performed by using ELISA. Bacterial vaginosis (BV) was diagnosed by microscopic examination of vaginal discharges. Also, fibrinogen level was determined. Enoxaparin (low molecular weight heparin) was prescribed to all infected patients.Results. It was found that the largest proportion of the study population was women aged 21–25 years, 70.65% of patients lived in rural areas. Among 205 women with a history of fetal loss, 81% were diagnosed with BV and CMV infection, and 19% had no infectious diseases. 95.8% of patients with CMV infection and BV responded positively to enoxaparin therapy, which was manifested by normalization of fibrinogen level and a favorable course of pregnancy. At the same time, 4.19% of women did not have an adequate response to treatment, which was associated with lower fibrinogen level.Conclusions. The presence of an infectious process leads to an increased level of inflammatory cytokines in the placenta, which can lead to the formation of blood clots, atherosclerotic changes with or without increased blood clotting factors, in particular fibrinogen, which reduce blood transport to the fetus. This, in turn, can lead to miscarriage, preeclampsia and premature birth. Enoxaparin is a safe and effective medication for preventing fetal loss in pregnant women with genital infectious diseases. Furthermore, it helps to reduce the frequency of fetal loss. However, studies on the effectiveness and safety of enoxaparin for the prevention of thromboembolic complications and thrombosis are currently insufficient, which requires further scientific observations.