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When a Miscarriage Isn't Nature's Way
A Closer Look at Autoimmune Disorders
Part Two
By Virginia Gilbert
In addition to anticoagulant therapy, APS mothers commonly undergo more fetal monitoring than women with low-risk pregnancies do. Roberta Montgomery, Kathy Hennessy and I had many extensive ultrasounds to track the condition of our placentas and amniotic fluid, as well as our babies' measurements. Roberta had two sonograms until 34 weeks, and then one a week until she delivered Bobby. Kathy's eleven ultrasounds of Emma Gwynne fill an entire videotape.
Because I had high levels of antibodies, I had up to two ultrasounds plus fetal heart monitoring every week from 26 weeks until 37 weeks, when I gave birth to my son, Jack, who weighed 6 pounds, 5 ounces. In fact, I spent so much time at my doctor's office that my OB, her staff and I joked that I should just rent a room down the hall. Still, the peace of mind I got from knowing my baby was growing properly was worth every nanosecond of the extra effort.
According to Dr. Danzer, the ideal medical team for a pregnant APSer includes a rheumatologist and a perinatologist (high-risk pregnancy consultant) in addition to an OB. However, Danzer admits that women living in smaller communities may not have access to physicians who specialize in treating autoimmune conditions. Dr. Seligman feels that most APS patients probably don't need a rheumatologist and would receive adequate attention with an OB and a high-risk consultant.
As a researcher, Dr. Lindsey Criswell, rheumatologist, is especially interested in identifying the genetic and environmental causes of APS. APSers often have family members with related autoimmune problems such as lupus, rheumatoid arthritis and thyroid disorders. Dr. Criswell obtained genetic samples from those with APS and/or lupus in an effort to determine the gene that predisposes an individual to develop various autoimmune conditions.
