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Recurrent Miscarriage

While the vast majority of miscarriages are isolated unforeseen and therefore unpredictable events; some women suffer from recurrent miscarriages. This means, they have a tendency to have consecutive recurrent pregnancy losses, typically in the first or early second trimester. One of the recognized causes of this distressing phenomenon is the Antiphospholipid Syndrome

Antiphospholipid Syndrome

It is now well established that some women who suffer recurrent miscarriage have abnormal antibodies, which may have a serious deleterious effect on the small blood vessels in the placenta, and therefore compromise the blood supply to the fetus.

This situation sometimes leads to miscarriage. Untreated, such an individual’s risk of miscarriage may be as high as 75-90%. This is the condition known as anti-phospholipid syndrome.

Diagnosing Anti-phospholipid syndrome (APS)

Antiphospholipid syndrome can be diagnosed through a blood test looking for specific antibodies. This test is by no means perfect. It is therefore possible to have a negative result in a person who has strong clinical indicators for the syndrome. The test can also be falsely positive.

The test will usually be done if a woman has a history of recurrent early pregnancy loss.

Treatment for anti-phospholipid syndrome in pregnancy

The management of this condition continues to evolve. The current popular method is a combination of low-dose aspirin and a form of heparin. The so-called low-molecular weight heparins are the ones mostly used. The heparin may otherwise be used alone without the Aspirin.

The treatment is continued to very late pregnancy or throughout the course of pregnancy. The treatment is in the form of injections usually self-administered, normally once a day. If the woman cannot stand the idea of giving herself the injections, the partner or another close family member living with the woman can take on the role. Mastering the technique is easy and straight-forward.

This treatment has been shown to dramatically help the affected women, raising likelihood of delivering a live baby from less than 25% to well over 75%.

Prevalence of antiphospholipid syndrome

This condition is uncommon. People with conditions known as connective tissue diseases (the most common being systemic lupus erythematosus, or SLE) are the ones at greatest risk. These conditions are, however, uncommon. Moreover, the antibodies are more frequently found in women with none of the known connective tissue diseases. These women will be at risk of recurrent miscarriage and will need appropriate treatment during their pregnancies.

It is important to emphasize that not all individuals with SLE will have the offending antibodies causing anti-phospholipid syndrome.

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