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Maternal (Expert Forum)
Anticardiolipids and Recurrent Fetal Loss
Patient medical question and answer from The Maternal and Child Health Forum. Health topic area and articles about newborn care
Anticardiolipids and Recurrent Fetal Loss
by Beth__0, Apr 27, 1999 12:00AM
Posted by Beth on April 27, 1999 at 13:42:02
I am 36-1/2 years old, have a 2-1/2 year old son and just experienced my second miscarriage in six months. Testing found my anticardiolipids to be at 10 where 0-6 is considered normal. My doctor instructed me to take baby aspirin daily when we start ttc again. I have several questions about this:
a) Is an acl level of 10 a very probable cause for miscarriage or not? I.e., am I treating the real problem or just stabbing in the dark at the first thing that was suspicious? Should I have more tests done that I've read about in this forum like for uterine structural abnormalities (my son was born C-section and I had a D&E for my 1st mc) or LPDs?
b) Should I be satisfied with taking baby aspirin or should I request heparin (the 2 mcs devastated my husband and I and I want to do the most I can to avoid it again)?
c) Before my 2nd mc my doctor put me on progesterone when we learned I was pg because my level was at 13 and they prefer 20 or greater. Should I be concerned about this as a factor and would taking it during my luteal phase help or hurt? What are the risks of taking it?
d) My doctor has said to wait 2 normal cycles before we ttc again...is this really necessary? I had this last mc at 6-1/2 weeks and so far a D&E is not indicated (but I just had my post-mc hcg test done today so don't know for sure if I'll need one).
Thanks for any help you may be able to provide.
Posted by hfhs.md.rcs on April 27, 1999 at 18:30:24
Dear Beth:
An anticardiolipin antibody abnormality is associated with miscarriage. The data are best for pregnacy loss in the second trimester. There is controversy regarding the significance of this phospholipid abnormality and early pregnancy loss.
Given the uncertainty of meaning, the safety of baby ASA, the increased challenges of using heparin, baby ASA seems a reasonable recommendation.
Other simple testing, especially when there are historic issues that may predispose to problems (cesarean section and uterine scar), is worthwhile.If nothing else, itgives some greater peace of mind.
Progesterone is another controversial, but very safe for mother and baby therapy. It does no harm physically.
It takes one menstrual cycle to heal the uterine lining and allow correct timing of pregnancy. Some women will experience transient lack of ovulation following a miscarriage (or any other end to pregnancy). There is an old literature that suggests an increased risk of miscarriage in the first cycle after a prior miscarriage. Finally, some women need time to heal emotionally. A recommendation of delay for two cycles is reasonable.
Keywords: miscarriage, anticardiolipin antibody
This informaton is providedfor education purposes andis not a medical consultation. If you have specific questions, please speak with your physician.
