Antiphospholipid antibody–associated recurrent pregnancy loss: Treatment with heparin and low-dose aspirin is superior to low-dose aspirin alone☆,☆☆,★
Section snippets
Subjects
All women were patients at the Southwestern Fertility Associates of the University of Texas Southwestern Medical Center. More than 600 women with recurrent pregnancy loss were evaluated before 50 women with the APA syndrome who consented to participate in this study were identified. This diagnosis was based on a well-documented history of at least three spontaneous consecutive miscarriages and APA levels that were ≥27 IgG or ≥23 IgM phospholipid units (>2.5 multiples of the median) on two
Patient population
Fifty women with the APA syndrome were sequentially assigned to treatment with aspirin alone or with heparin plus aspirin after a confirmed pregnancy test. As shown in Table I, there were no significant differences in the patient age at entry, total number of prior pregnancies, prior live births or miscarriages, gestational age at loss, or percentage of losses that occurred before 12 weeks, between 13 to 19 weeks, or after 20 weeks of gestation. Each woman had an APA level of at least 27
COMMENT
Recurrent pregnancy loss, defined as three or more spontaneous consecutive abortions, affects approximately 1% to 2% of reproductive-aged women in the United States.1 Various causes of recurrent pregnancy loss include genetic, anatomic, endocrinologic, immunologic, microbiologic, and as yet unknown factors. Of the immunologic causes, several investigators have correlated increased levels of APAs and the presence of lupus anticoagulant with increased obstetric complications including IUGR,
Acknowledgements
I thank the following physicians who helped care for patients during their pregnancies: A. Ahmed, J. Arias, B. Axmann, S. Bakos, K. Bradshaw, M. Cane, J. Cornwell, B. Crockett, U. Crosby, M. Davis, K.M. Doody, J. Dorsett, R. Dowling, C. Edman, J. Gilbertson, J. Goss, A. Guerami, S. Hoffman, E. Hunt, A. Johns, J. Kapsos, C. Kinney, C. Kutteh, W. Maxwell, T. Neel, J. Nelson, M. Read, R. Reinmund, K. Reisler, E. Silverstein, B. Stettler, S. Stone, L. Tatum, G. Theilen, K. Trimmer, L. Umholtz, M.
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Cited by (0)
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From the Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center at Dallas.
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Reprint requests: William H. Kutteh, MD, PhD, Division of Reproductive Immunology, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75235-9032.
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0002-9378/96 $5.00 + 0 6/1/69803