Human Reproduction, Vol. 10, No. 12, pp. 3301-3304, 1995
© 1995 European Society of Human Reproduction and Embryology
research-article |
High prospective fetal loss rate in untreated pregnancies of women with recurrent miscarriage and antiphospholipid antibodies
1Department of Obstetrics and Gynaecology 2Department of Haematology, St Mary’s Hospital Medical School London W2 1PG, UK
Correspondence: 3To whom correspondence should be addressed
Antiphospholipid antibodies (APA), lupus anticoagulant (LA) and/or anticardiolipin antibodies (ACA), are associated with thrombosis and recurrent miscarriage. We studied the outcome of 20 pregnancies in women (median age 32 years; range 23–41) with APA (14 LA positive; three immunoglobulin (Ig) G ACA positive; two IgM ACA positive and one LA and IgG ACA positive) and history of recurrent miscarriage (median 4; range 3–11) who declined pharmacological treatment in their next pregnancy. Comparison was made with a cohort of 100 consecutive women (median age 33 years; range 23–44) with recurrent miscarriage (median 4; range 3–10), in whom no underlying cause to account for their pregnancy losses was found. Of the 20 women with APA, 18 (90%) miscarried compared to 34 of the 100 women (34%) with normal investigations (P < 0.001). The majority (94%) of miscarriages in women with APA occurred in the first trimester. Fetal heart activity was seen prior to fetal death in 86% of women with APA compared to 43% of women with normal investigations (P < 0.01). The first trimester loss of embryonic pregnancies is the most common type of miscarriage in women with APA. This may be a result of defective implantation and subsequent placentation.
Key words: antiphospholipid antibodies/pregnancy/prospective study/recurrent miscarriage
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