The Hemophilia and Thrombosis Center of Nevada 2020 W. Palomino Lane Suite 110 Las Vegas, Nevada 89106 702-385-2702
since May 5, 2008 Last updated May 5, 2008 webmaster RIS |
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PREGNANCY AND ANTICARDIOLIPIN ANTIBODIES
I am a 38 yr old female who is looking for some direction when considering whether or not I want to try to become pregnant. 10 yrs ago, had 4 miscarriages during a 2 year period. These miscarriages varied between 8, 12, and 16 weeks. After the forth miscarriage, I had several tests completed at the Baylor University facility in Houston and the only thing that they could tell me was that I had elevated levels of the anticardiolipn antibody in my system. At that time, they really did not have a great deal of information on how to proceed.
I have not attempted to become pregnant since that time and have also re-married during this 10 year period. Now, between my age and the antibody, I am uncertain of how to approach this. I've asked my regular ob/gyn and they were educated enough in this particular area to give me advice...who do I talk to? A fertility specialist?
Any direction you can provide would be greatly appreciated. Ronda I would begin by speaking to a hematologist with expertise in clotting disorders. He or she will probably recommend a high risk obstetrician that is experienced in this area. Typically pregnant women are continued on low molecular weight heparin with or without aspirin to ensure that you go to term and deliver a healthy baby. Be careful of any fertility drugs, especially hormones which may increase your risk of blood clots.
I am 30 year old, and I am 3,5 months pregnant of our 2nd child. The pregnancy of our 1st child went well and I gave normal birth. With my first pregnancy I had bleedings twice, but it turned out to be placenta previa (fortunately the placenta went up in the 7th month). I never had any miscarrage or problems getting pregnant. There are no cases of hart attacks in my family. Still, somehow in the beginning of my second pregnancy my obgyn let me check my Aca and it turned out like this: Aca IgG 9,9 and IGM 82,2. Then he gave me aspillets twice a day (which I have been taken for a bout a month now) Recently we checked again and it was IgG 9,975 and Aca IgM 47, 352. They say it is still to high and I should get injections everyday. Now what will you usually do in my case and with my history? What kind of medication? Are the injections every day really necessary or could I just stay on aspillets? I really would like to know as soon as possible cause this comming tuesday they want to know the answer if I want to go on with the injections. Since I live in Indonesia, information is very rare about this matter. Our insurance will not pay for the injections, and they are really expansive. That is why I would really like a second opinion. Thanks for your help, and thanx for having a website about ACA.
It is unclear why the
tests were ordered in the first place and therefore the significance
clinically is not known. If you test normal blood donors, a portion will
be positive for ACA however without a history of clotting, missed abortions,
or low platelets there is no clinical significance or predictive capability as
to whether there are problems expected in the future. In addition,
treatment is only indicated in those persons with ACA who have had difficulty
attributable to this syndrome. If a person tests positive and has never
had a blood clot, no treatment is needed. I would recommend that you
speak to a high risk OB used to dealing with this disorder and also a
hematologist to ensure that treatment is or is not needed.
Goodmorning. I was diagnosed with anticardiolipin
syndrome about 7 years ago. I have 5 children in which 4 were carried with no
difficulties. With the last one (after confirming the diagnosis) I was on
injections of heparin 2x day for the duration of the pregnancy. At the time
of the initial diagnosis they tested me right after a D&C from a failed
pregnancy. They decided to do the test because it was the second one in 6
months. The test came back that I had it but just barely. My question is
this. How do I know if I have this on a permanent basis or if this is
something that's just pregnancy induced? Thanks so much for your time!
Take Care,
Teri
This is an excellent questions that I am not sure has a true answer. This syndrome is poorly studied and so much of what we know is from large cohort studies, retrospective review of patient's charts, and testing of blood bank donors. Therefore, the true incidence of the development or the significance in all patients who become pregnant is not known. Nor is it known if this level waxes and wanes as we think, or eventually disappears after pregnancy. Since persons with this antibody, unless related to the use of antibiotics, are commonly treated for it for life, I would err on the safe side and recommend that treatment if needed be continued with future pregnancies, and that you always take precautions to prevent the development of blood clots. This includes early mobility after surgery, the use of heparin shots while immobilized, no use of hormones and walking and moving around on long flights or drives. Hopefully with the current research push for persons with clotting disorders, answers will soon be forthcoming that will help you with your medical questions.
I am 33 years old and I have two children. Before I had my children, I had two miscarriages. After my second miscarriage, my OB/GYN ran some blood tests that revealed a borderline high anticardiolipin antibody. Therefore, with both of my successful pregnancies, I took on e baby aspirin a day. Then in April of 2002, I had a DVT in the right groin and a PE in the left pulmonary artery. I was on Coumadin for 6 months and I had to take Lovenox as well for a couple of months. I was taking 12.5 mg of Coumadin for quite some time, with m y INR still being subtherapeutic. I was tested for many, many things that never explained the cause of the PE and the DVT. My hematologist checked the anticardiolipin antibody and it was normal. I have been told that if I have another pregnancy, I would need to take heparin throughout the pregnancy. My question is, do you think all of this is related? Does the anticardiolipin antibody fluctuate? What does this mean for an occurence of another clot? How would I go about preventing further problems? Shannon The testing for anticardiolipin testing may be limited in that there are four antibodies, however standard testing can detect two, the anticardiolipin and antiphosphotidyserine antibodies. There is also a test for the cofactor beta 2 glycoprotein I. Some centers make their own mish mash testing that includes all four antibodies and may improve the yield of testing, however this is not standardized and therefore poses additional problems. Therefore, it is first important to identify what testing you had obtained and the results. In addition, the antibodies do fluctuate so it is important that you were tested on at least two occasions. Persons with this disorder typically have recurrent miscarriages which may be treated to improve the outcome of pregnancy and blood clots. If blood clots occur and the antibody is present, long term therapy with blood thinners, warfarin, is indicated to prevent additional blood clots since the risk is so elevated in these persons. We have found that it is difficult to regulate the warfarin in persons with this disorder and they must be followed closely, usually weekly, to achieve a therapeutic level. Other tests may be of benefit in the regard. Good luck I was on my second pregnancy when I had a blood clot burst and I thought it was a miscarriage. The doctors found out I had a blood clot attached to my placenta which eventually dissolved we think. Then they told me on my third child I have anticardiolipin. Am I supposed to be on medicine? Will I eventually die withoug medicine because I do not have insurance. Are there any symptoms other than blood clots? Kim
In response to your questions. If you have had a
blood clot in the lung, leg, arm, stroke, or heart attack, and have this
antibody, then life long therapy with blood thinners are indicated to prevent
additional blood clots which may be life threatening.
Hi,
I wish I would have found your web
site a while ago. Thank you for expanding your support. I am a 37 year old
female. I have polycystic ovaries and took Clomid to help me ovulate in
1999. I got pregnant right away then developed an extensive DVT in my left leg
and miscarried. I was diagnosed with anticardiolipin antibody syndrome, put on
lovenox, then heparin and eventually just coumadin. I was tested every 3
months for a year (2001) for the cardiopilin antibody (anticoagulant panel)
and my levels were normal. I came off coumadin January 2002 and started the
81mg aspirin. The doctor wants to test yearly using the same tests. I am
currently waiting on the results. I want to try to get pregnant again and
would like to know if I will need to take blood thinners during pregnancy if
my levels are still normal. If I have normal levels for 2 years does this
decrease my chance of getting a blood clot ever again ( wishful thinking!)?
My doctor does not know if pregnancy increases the antibody or if the
elevated antibody causes a miscarriage. I would really appreciate any info
you can give me. Thank you. Lisa
In response to your questions. We do not usually do
research on pregnant women, therefore there is limited answers to your
questions.
Hello,
I am a 33-year-old mother of a 2
1/2 year old little boy. This past year I experienced two 1st trimester
miscarriages within 6 months of each other. Recently I was diagnosis with two
positive tests for the anitcardiolipin antibody. My question is if this is at
all related from taking birth control pills. Prior to conceiving my son I had
been on the pill for 10 years straight. I know that one of the many side
effects of taking the birth control pill could be blood clots.
Just wondering if there were any
connection between the two?
The cause of the anticardiolipin antibody is not known. It has been linked to antibiotic therapy, however this does not usually result in blood clots, only a positive test. Birth control pills are associated with blood clots as the hormones increase the bodies propensity to form blood clots. Your development of this syndrome cannot be linked to any medication that you took previously. The anticardiolipin antibody syndrome is associated with recurrent miscarriages. Therefore, this may be related to your past experience.
Hi.
I was told by my doctor that my miscarriages were caused by anticardiolipin. I am now scared to get pregnant. Should I take a baby aspirin everyday of my life? Does pregnancy increase the chances of having a blood clot?
While you do not give details of your condition, the literature supports
testing for coagulation abnormalities in patients that have had recurrent
miscarriages depending upon when in the pregnancy these have occured. While
noone can prove that the anticardiolipin antibody causes the miscarriage,
there is an association in some people. There is much literature on patients
who become pregnancy with this condition and the use of heparin products to
improve the likelihood of a normal pregnancy and healthy baby. A high risk
obstetrician should be consulted prior to your deciding to become pregnant
again.
I had a dvt and pe during my 5th pregnancy. I was on lovenox and now on coumadin. I had a greenfield filter inserted at 12 wks preg. I was told I had a positive lupus anticoagulant during the pregnancy(drawn while on a heparin infusion), and a prothrombin gene defect. I delivered a healthy baby one year ago. Will I ever be able to know for sure if I have antiphospholipid syndrome because I must take coumadin? I have been to several specialists and none have suggested following up on it and I never really wanted to know. Do you think it is important to pursue this and can you give me more information on prothrombin gene defect? I am a critical care nurse and would appreciate any information. Thank you
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