When a Miscarriage Isn't Nature's Way

A Closer Look at Autoimmune Disordes

By Virginia Gilbert

1. Positive antibodies test (includes lupus anticoagulant antibody, anticardiolipin antibody, and false positive syphilis screen) on two separate occasions, at least 8 weeks apart;
2. Recurrent fetal loss
3. Low platelet count
4. Clotting events

Seligman stresses that not every woman who tests positive for the antibodies has APS. An estimated 2 to 5 percent of women have elevated antibody levels, but only 10 to 20 percent of this group have problems in pregnancy. For those in the high-risk category, possible pregnancy risks include:

1. Miscarriage
2. Clotting events, also postpartum
3. Prematurity and intrauterine growth retardation (IUGR)
4. Pre-eclampsia

When a woman with undiagnosed, untreated APS gets pregnant, her body may begin to reject the fetus. Antibodies form tiny blood clots that enter the placenta and shut off the supply of oxygen and nutrients to the baby, resulting in miscarriage. Although doctors used to wait to diagnose APS until a woman had three consecutive pregnancy losses, many OBs now try to prevent this needless suffering by testing a patient after one or two losses.

Roberta Montgomery of Los Angeles had a normal pregnancy with her son, Roland, now 2 years old. But her second pregnancy ended at 11 weeks after a previous ultrasound had shown a healthy fetal heartbeat. Thinking this an unusual development, Roberta's astute OB checked her for APS and found she had moderate levels of antiphospholipid antibodies. Because Roberta wanted to get pregnant again, her OB sent her to Dr. Hal Danzer, a Beverly Hills fertility specialist. Dr. Danzer prescribed two blood thinners – baby aspirin and heparin – to prevent clots. Both medications are considered safe during pregnancy and heparin has proven extremely beneficial in combating miscarriage and intrauterine growth retardation.