APS and Pregnancy:
Many women with antiphospholipid antibodies do not have any problems during
pregnancy. However some women with antiphospholipid antibodies may have a
miscarriage during the first 12 weeks. This is because the antibodies inhibit
the growth of the early foetal cells.
In some pregnant women antiphospholipid antibodies can cause thrombosis in the
small and delicate blood vessels of the placenta. The placenta is then unable to
supply the foetus with enough nutrition, so the foetus may stop growing and may
die in extreme cases. Sometimes damage to the placenta prevents the foetus
growing to normal size, so the baby is small at birth. This is known as
intrauterine growth restriction.
In other cases the damaged placenta may lead to pre-eclampsia in the mother.
Pre-eclampsia during pregnancy is a potentially dangerous condition, resulting
in swelling, leaky kidneys and high blood pressure.
The best way of predicting how well a pregnancy will progress is by looking at
what has happened before. If a woman with antiphospholipid antibodies has
previously had a normal pregnancy, then it is likely that she will do so again.
One area requiring further research is to find a way of predicting whether
women with antiphospholipid syndrome who are planning their first pregnancy will
have any problems, and if so, what sort of problems are likely.
Treatment of APS:
As for other thrombophilias, treatment for APS involves giving anticoagulant
drugs to prevent the antibodies from causing further thrombosis. The three
drugs commonly used are aspirin, warfarin and low molecular weight heparin.
Aspirin is given in small doses, such as 75-100mg daily (one quarter aspirin
or 'baby aspirin'). It has long been established that aspirin thins the blood by
reducing the function of platelets. In cases of recurrent miscarriage, for
example, giving aspirin alone has dramatically improved success rates.
If someone has already had a thrombosis, then aspirin is not strong enough to
prevent a recurrence. In this case warfarin is usually given. Warfarin
(Coumadin) is an anticoagulant drug, used worldwide as a blood-thinning agent.
For example, most people with a deep vein thrombosis in the leg are given
warfarin for six months.
For those with APS, it is usually recommended that warfarin treatment is
indefinite and that the blood thinness level is kept higher than for most other
conditions. The INR (international normalised ratio) measure of blood thinness
for people with APS is kept at 3-4 when they have had a stroke or arterial
problem, whereas for patients with other thrombotic risks it tends to be kept at
2-3.
Heparin is usually given to people with APS before and after surgery and
during pregnancy. This is because its anticoagulant effects, unlike those of
warfarin, can be easily reversed. Also heparin can be used safely throughout
pregnancy, whereas warfarin can affect the developing foetus, especially if
taken during the first 12 weeks.
Many women with antiphospholipid antibodies do not have any problems during
pregnancy. However some women with antiphospholipid antibodies may have a
miscarriage during the first 12 weeks. This is because the antibodies inhibit
the growth of the early foetal cells.
In some pregnant women antiphospholipid antibodies can cause thrombosis in the
small and delicate blood vessels of the placenta. The placenta is then unable to
supply the foetus with enough nutrition, so the foetus may stop growing and may
die in extreme cases. Sometimes damage to the placenta prevents the foetus
growing to normal size, so the baby is small at birth. This is known as
intrauterine growth restriction.
In other cases the damaged placenta may lead to pre-eclampsia in the mother.
Pre-eclampsia during pregnancy is a potentially dangerous condition, resulting
in swelling, leaky kidneys and high blood pressure.
The best way of predicting how well a pregnancy will progress is by looking at
what has happened before. If a woman with antiphospholipid antibodies has
previously had a normal pregnancy, then it is likely that she will do so again.
One area requiring further research is to find a way of predicting whether
women with antiphospholipid syndrome who are planning their first pregnancy will
have any problems, and if so, what sort of problems are likely.
Treatment of APS:
As for other thrombophilias, treatment for APS involves giving anticoagulant
drugs to prevent the antibodies from causing further thrombosis. The three
drugs commonly used are aspirin, warfarin and low molecular weight heparin.
Aspirin is given in small doses, such as 75-100mg daily (one quarter aspirin
or 'baby aspirin'). It has long been established that aspirin thins the blood by
reducing the function of platelets. In cases of recurrent miscarriage, for
example, giving aspirin alone has dramatically improved success rates.
If someone has already had a thrombosis, then aspirin is not strong enough to
prevent a recurrence. In this case warfarin is usually given. Warfarin
(Coumadin) is an anticoagulant drug, used worldwide as a blood-thinning agent.
For example, most people with a deep vein thrombosis in the leg are given
warfarin for six months.
For those with APS, it is usually recommended that warfarin treatment is
indefinite and that the blood thinness level is kept higher than for most other
conditions. The INR (international normalised ratio) measure of blood thinness
for people with APS is kept at 3-4 when they have had a stroke or arterial
problem, whereas for patients with other thrombotic risks it tends to be kept at
2-3.
Heparin is usually given to people with APS before and after surgery and
during pregnancy. This is because its anticoagulant effects, unlike those of
warfarin, can be easily reversed. Also heparin can be used safely throughout
pregnancy, whereas warfarin can affect the developing foetus, especially if
taken during the first 12 weeks.
24 comments:
HI BUNNIE! "NO FEAR!" THAT'S WHAT YOU SHOULD PUT INTO YOUR SYSTEM. CONSIDER THESE:
1. I LOST MY 1ST BABY AT 22WKS AOG
2. LABOR WAS INDUCED (ABORTION PILLS & THROUGH IVs) BUT WAS UNSUCCESSFUL
3. I HAD TO BE OPERATED ON VIA C-SECTION. WE DIDN'T HAVE MUCH MONEY BUT SOMEHOW GOD WORKED EVERYTHING OUT...
4. THE PAIN OF GOING HOME WITHOUT A BABY AFTER THE OPERATION
5. FEELING MY BREASTMILK ON MY SHIRT 2 DAYS AFTER I GOT HOME... EMPTINESS WAS EATING ME UP.
6. WANTING TO GET PREGNANT AGAIN BUT HAD TO SAVE FIRST FOR LAB TESTS
7. DURING MY 2ND PREGNANCY: 6 WEEKS OF BED REST- FROM MY 5TH TO 10TH WEEK
8.CONTRACTIONS AS EARLY AS 26AOG!
9. CHRISTMAS AND NEW YEAR IN BED (SPOTTING AGAIN. CBR AGAIN! )
10. BED REST FOR THE LAST 6 WEEKS OF PREGNANCY
11. ANXIETY OVER REACHING THE TARGET: AT LEAST 34AOG.
12. HIGH BP JUST PRIOR TO CS AND FOR 3 MONTHS AFTER DELIVERY
13. POSTPARTUM BLUES WHICH WENT AWAY ONLY AFTER I WENT BACK TO WORK
I WAS JUST 25 WHEN I LOST MY FIRST BABY. I WAS 28 WHEN I GAVE BIRTH TO ELLA.
BUN, I WENT THROUGH ALL THAT WITH MUCH PAIN AND FEAR BUT BY GOD'S GRACE I AM NOW ENJOYING MOTHERHOOD TO THE FULLEST! MY BABY'S ALREADY 14 MONTHS OLD! APAS IS KINDA RARE BUT YOU KNOW I HAVE AN OFFICEMATE WHO ALSO HAS IT AND HIS LITTLE BOY TURNED 2 LAST JANUARY! SHE HAD TO INJECT HEPARIN AND WENT THROUGH MORE DIFFICULT TIMES THAN I... HERS IS OF A HIGHER LEVEL. BUT GOD IS GOOD! COUNT ON THAT!
hello bunnie!
God is really good! my sister in law has APAS but she will have her 2nd child soon, maybe next week...she had to inject clexane too everyday for several days and to think, this is her 2nd child.
Hello! We lost our baby for the third time barely two weeks ago.
My wife, although she has gone back to work and is trying to live as normally as she can, i dont think she's the same.
She cries at night when she doesnt think i can hear her. The doc says she has this rare conditions called APAs.
She's 36 already. We have to wait for another year if we decide to try again. But I feel so sorry for her and she doesnt know it. I wish i can share in the pain she has to go through whenever she loses our baby. I wish she understands I also feel her loss and her sorrow.
It makes me cry everytime i remember how beautiful she looked and how happy she was the first two times she got pregnant. But on the third time. It was as if she already knew it might happen again. And she went on in fear for two months until it did happen again.
I wish there was a way to help her. We dont know what to do. I dont know how to make her happy anymore.
Hi Bunnie! My sister had two miscarriages prior to treatment for APAS. On her 3rd conception, she religiously obeyed all the treatments and offered everything to God. It was a real sacrifice for her and her husband. After 7 months, she gave birth to a very lovely daughter. It was the happiest moment for all of us, her family. The baby is the greatest gift received from God. Pray, pray and pray. :-)
HI BUNNIE!I'M AN APAS PATIENT,I'VE BEEN THROUGH 4 UNSUCCESSFUL PREGNANCY,THE 4TH ONE WAS AN ECTOPIC PREGNANCY WHEN MY OBGYNE REFERRED ME TO AN IMMUNOLOGIST AND WENT THROUGH A LOT OF BLOOD TEST,THANKS A LOT TO MY DOCTORS & TO GOD I'VE GOT A SUCCESSFUL 5TH PREGNANCY AND MY BABY IS NOW 18 MOS.,WHAT A WONDERFUL BLESSINGS FROM GOD AND MY BABY BOY GIVES US HAPPINESS AND MAKES ME A FULFILLED MOTHER.
after losing 7 kids to this rare disease. i had my 1st apas baby - phoebe.after so many blood works,LIT treatmnt, heplock - heaprin was injcted 4 times a day with my case.progesterone tx oral and injctable.protein based diet.vitamins that will protect my liver, my bones. i reached motherhod at 29 and after 9 yeras of battling this illness.i will always remember that journey i took just to reach this far.infarcts were still found in placenta. g;ad that oxygen and water has not been cut off.perhaps the good LORD saw my deepest desire to be the mother i always prayed for...
hi miss bunnie, reading the article makes me sad. me too had that. i'v had a miscarriage before and like most of the comments posted, me too have fears on attempting again but im currently on my 22 wks AOG and every thing seems well with the help of Mama Mary. I'm on aspirin and innohep.my OB is a high risk pregnancy OB, Dra. Marivic Torres,from MCU . my immunologist, Dra. Aleta and hematologist, Dr. Edwin Trinidad are from medical city and all the test says am no longer APS patient. but to be on safer side my OB still wants me to undergo innohep treatment. If I may suggest consult your immunologist and hematologist first before trying to have your baby first. we're lucky to have loving husbands.
hello bunnie! I was searching for any Info i could get about APAS on pregnancy. I found your blog and the comments that other women have to go through..
I also had miscarriage twice. It was indeed so painful & depressing. My Ob-gyne is suspecting me of having APAS. My husband and I will go consultataion to an immunologist by next week. I am praying that evrything will be ok. I am willing to go treatment if ever. Though Im hoping i will be negative for APAS.
If i did not loss my baby last june on his 12th week, I am supposed to give birth in time before xmas. but God has another plan. I have to admit His ways. I know God will surprise me one day.
I hope you have good news to share to us on your next blog. you are a pretty lady and blessed also to have a loving husband.
God bless us all.
May God hear our prayers and give our heart desires in HIS time. ;)
I lost my first baby 2007 7weeks old and the next year 2008 i concieved again but I lost it again 9weeks old.... Its hard for me to accept it that twice miscarriage I dont know what to do why it happen to me, I dont do anything but still they lost. Now I'm afraid to getting pregnant again coz it might be ended again to miscarriage and lost of my little angel.
hi! i was also diagnosed to have APAS. i was childless for 6years because of PCOS (poly cystic ovarian syndrome), and later after getting the red + on the preg test (w/c i do every month for 6 years!), it was unfortunate that i was also positive for apas. had spots on the 6th week and advised for CBR until delivery!!! so i did, setting aside all the worries of losing my job and not able to pay my credit card on time. while pregnant, i had gestational diabetes and even carpal tunnel syndrome... jul 22 2009, i delivered via CS (supposed to have normal delivery but baby changed head position while i'm on labor)...now, Neo is a healthy 18 month wise boy.. his real name is napoleon, because he has been a very brave fetus in my tummy. we thank God at all the trials and joys of our lives. i always pray of success and not losing hope for other wives who has apas too
Hello. I've had 2 miscarriages in a year. The 1st one I lost at 7 weeks and the other one at 8 weeks. I am a nurse and thought I knew how to take care of myself. But there was a time when I even blamed myself because I was so confident that the first miscarriage was just an accident. I quit working after that so we can try for the 2nd time. Unfortunately,I still lost the 2nd baby at 8 weeks, after 1 week of spotting while on duphaston and duvadilan.
My APS result last week showed a slight elevation of my APTT.I am now on aspirin and is planning to have a baby again soon.
I am still in fear of losing another child and I promised myself that this time, I'd really do everything the OB says, if it means I can't go out or I have to stay in bed for the rest of the pregnancy. I've already set my plans of working again aside. I plan to have a baby no matter what happens. I still worry a bit about the next pregnancy but I know that God knows what's going on and that He is in control. He great plans for us even when things are hard to understand. We are very fortunate that our husbands are very supportive and understanding. Thank you all for sharing your struggles and triumphs. It really helps. Godspeed.
hi bunnie! Just offer everything to God...I already have 1 boy and he is 3 years old now but the two consecutive pregnancies, sadly failed. One on 2010 and the latest is 2012. I just had my operation March 2012 and got depressed so much when I found out that I almost had twins...the pain of going home without the babies is so painful...I am currently being worked up on APAS and thyroid problems (and I am hoping I am free of anything)in preparation for my next pregnancy as my hubby and I wouldn't want to stop trying. I feel so much for you but God is so good if you will just believe that He will give it to you on the right time...I'll pray for you
hi there..i have a daughter,she is on her 8th weeks now.she's 24 and my eldest, she's an SLE and APAS patient. My feelings are mixed right now,,fear and worries eating me up.Cant think of what might happen,,her pregnancy is under care of her Oby gyne Aunt. I know there are lots of bloodworks and medical planning to undertake for her and the baby. Baby is always a blessing, however I cant think of anything right now but to pray and let God make his wonders.
I appreciate this blog and the comments that followed. I also have APAs, and like the women who posted here, I'm hoping that my husband and i would have a baby soon. We lost our 7 week baby just last month.
I have APAS, I have 6 miscarriage. 5 of my pregnancy was all blighted ovum, but my 6th pregnancy last for 23 week because we tried to treat it by having heparin and lots of meds. Its really painful going home from hospital with out a baby in our arms. Now Im 8 weeks pregnant, but my ultrasound is not good. Although we still have the baby, the sack is not in ood shape. The doctor said Im having a contractions. Now we really dont know what to do.. Fight or give up? Maybe God has other plan for us, we may not accept it easily but I kow everything will be ok.. Hurted but still thankful because I have my husband beside me..
Hi! After 5years on my 2nd miscarriage I decided to get pregnant again but I consulted first to obygnye in St. Lukes hospital, I tell everything to my oby about the twice muscarriages and my oby diagnos that I have APAS so advised me to under go foe APAS test and histonogram ultrasound by next month, if the APAS test is positive she will give a medication for me to treat before I concieved next year, but I'm still afraid to get pregnant because one of my officemate is an APAS patient also and she was 2months pregnant and her doctor adviser to CBR and she injected twice a day of heparin but still she lost her baby last week and she was confined in asian hospital, i thought if your in medication there is a big chances to not losing your baby but in the case on my officemate she lost again her 3rd baby so it makes me scared that might happen to me. I believe in prayers and miracles that mama mary and my angels will guide me and protect me and god will help me.
Hi. I just want to share my appreciation for this post. It helps a lot to know that I am not alone in this kind of situation. And it's encouraging to read a lot of successful stories too. My OB believes that I have APAS too, although we still have to go through the tests to confirm it. I lost my first pregnancy due to fetal death and had to have a D&C. Now, I'm at 24 weeks and my doctor put me on aspirin when I had spotting last Feb. I didn't really think much about APAS until my OB said last week that my placenta age is already for 8-9 months and that my baby is too small, then I got worried and did a lot of research about it. I still have a lot of questions, but knowing that I am not alone in this fight assures me that if other women were able to overcome and conceive and have healthy baby/babies despite this condition, then by God's grace I know I will be successful too.:) Thanks again for the posts and comments.:)
Hello ... my Ob said she think i have APAS because i have 2 miscarriages at 20wks of pregnancies ... i had C section for the second time bec of the high blood pressure ... may i know how much the test for ApAS ?? Thank u so much ..
Hello, would it be okay if I shared the link to your blog on my cousin's GoFundMe story? (It will be on the section where I describe what APAS is, and your blog pretty much sums it up:))She has APAS and is currently on her 6th month but is experiencing some complications. The family's fund has been severely depleted since they had also tried all other methods to conceive like IVF here and abroad, etc and just recently discovered that she has APAS. Thank you very much!
Hi I'm Liz. Thank you so much for sharing this comment. I'm a nurse. I experience miscarriage 3 times.
1st pregnancy last 2013 it was 5 months and 3 weeks. It was FDIU (fetal death in utero) it was found out that my baby don't have heart beat. I undeegine D and C. After 3 years Got pregnant again on my second baby last 2016. But it only last 12 weeks. This year 2018 of january got pregmant again this time I was Complete bed rest just quit my job. However I lost it again for 8 weeks got my D and C on March 2018.
This moment I'm on my 4th pregnancy. My Obgyn referred me to hematologist Obgyn. Diagnosed with APAS. Im on 6 weeks today but i do have spotting this moment.
My experience was so terrible. Sometimes I cried because I'm so afraid with my condition. Even if I'm a nurse can't help my self to calm down.
This is not normal anymore.
Hi I'm Liz. Thank you so much for sharing this comment. I'm a nurse. I experience miscarriage 3 times.
1st pregnancy last 2013 it was 5 months and 3 weeks. It was FDIU (fetal death in utero) it was found out that my baby don't have heart beat. I undeegine D and C. After 3 years Got pregnant again on my second baby last 2016. But it only last 12 weeks. This year 2018 of january got pregmant again this time I was Complete bed rest just quit my job. However I lost it again for 8 weeks got my D and C on March 2018.
This moment I'm on my 4th pregnancy. My Obgyn referred me to hematologist Obgyn. Diagnosed with APAS. Im on 6 weeks today but i do have spotting this moment.
My experience was so terrible. Sometimes I cried because I'm so afraid with my condition. Even if I'm a nurse can't help my self to calm down.
This is not normal anymore.
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