Medical Q&As

Antphospholipd antibody - miscarriage?

I would like to find out more information on the uses of aspirin or heparin in treating recurrent miscarriages due to antiphospholipid antibody?

There is a syndrome known as APS (antiphospholipid antibody syndrome) in which tiny blood clots are formed in the placenta that block the supply of nutrients and oxygen to the foetus thereby resulting in miscarriage. APS is regarded as a form of autoimmune disease, which means that the body’s immune system forms antibodies against some of its own tissues that it regards incorrectly as being foreign. The antigen antibody reaction results in the formation of tiny microscopic clumps that contribute to the formation of the blood clots that obstruct the flow of blood through the placenta. Women with APS may experience the heartbreak of repeated miscarriage if the condition is not recognised and treated. Heparin is an anticoagulant, which means that it prolongs the time that it takes for blood to clot thereby preventing the development of the tiny clots that plug the placenta. Heparin is administered by injection and women using this therapy are usually instructed in self-injection because the drug usually has to be administered twice a day. Heparin is safe to use in pregnancy and has no reported adverse effects on the foetus. Women on this form of therapy are usually switched over to aspirin therapy once the foetus has reached the stage of being viable. It would not be desirable for a woman to be on heparin at the time of delivery because of the risks to her in having a prolonged clotting time. In less severe cases of APS aspirin may be used in preference to heparin because the level of antibody reaction may be such that the use of aspirin is sufficient to achieve the desired level of anticoagulant effect. Aspirin reduces the stickiness of platelets, which are small cellular elements in the blood that aggregate together to form tiny sticky plugs. This so-called platelet plug is the first step in the clotting process.