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Lupus

Anti-cardiolipin antibody & miscarriage

09/13/2004

Question:

I miscarried at 7.5 weeks and have been told I have low positive anti-cardiolipin antibody. I am trying to get pregnant again, should I be taking low dose aspirin daily (now?). I am 35 and this is my 2nd miscarriage (first one was 15 yrs ago). Your help would be appreciated. Thank you,

Answer:

Pregnancy loss can be seen in up to 50% of patients with high titer anticardiolipin antibodies. There are several types of such antibodies and the Ig G type is the one that correlates the most with pregnancy loss. The other types Ig M and Ig A correlate somewhat less with pregnancy problems.

In patients with high titer anticardiolipin antibodies pregnancy loss was prevented in up to 70% of cases with low-dose aspirin alone. Some research studies showed that combination of aspirin with the blood-thinner heparin was more effective in protecting from pregnancy loss.

My advice is to check the antibodies twice  6 weeks apart and see if they are consistently positive, what titer and what type. If the titer is consistently moderate to high you should be followed by a rheumatologist and high-risk pregnancy obstetrician and decide together what would be the best regimen for you during the pregnancy. You also should know if you have just anticardiolipin antibodies or a connective tissue disease and if the anticardiolipin antibodies are the only ones found to be positive.

 

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Response by:

Yolanda   Farhey, MD Yolanda Farhey, MD
Associate Professor
College of Medicine
University of Cincinnati