academic article discussing the APS criteria for 2 or 3 miscarriages

Hi there

as some of you might know I had a big discussion this week with my gynea who wanted to hold on to the criteria I should have 3 miscarriages before I could be diagnosed with APS. Since I had a healthy pregnancy with no problems (and a beautfiul daughter) and after that only 2 miscarriages it wouldn't suffice that I had last 3 months 2 blood tests in 12 weeks time showing APS. Being now pregnant she didnt think I should take heparine, because formally not falling under the 3 miscarriages rule.

I just found a very recent academic article of jan 2013 exactly discussing this critera of having 2 or 3 miscarriages. Since most gynae want to work evidence based, this might just be the article to convince not to wait till you have 3 miscarriages. You can find the whole article here:

fertstert.org/article/S0015...

conclusion

The number of preceding miscarriage, type and sequence of previous pregnancies, and maternal age were not associated with APS in women with RM. There is no increased diagnostic yield for APS after three miscarriages rather than after two miscarriages and no increased diagnostic yield for APS after consecutive miscarriages rather than after nonconsecutive miscarriages. Therefore, APS testing should be considered for all women with two or more miscarriages.

I hope this works for my gynaecologist.I'll speak with her tomorrow and thought of all the other women struggling with the same issue. I hope this wil help you too! Good luck

Marije

6 Replies

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  • I was just diagnosed last summer with APS after some pre-op lab work came back abnormal. I had 2 miscarriages many, many years ago and now the doctor is wondering if I had APS back then and never knew it. I wish you luck with your ob/gyn and any other women that are struggling with this same issue.

  • Well done with this, and please keep in touch and let us know of any progress. Mary F x

  • Thank you for sharing this. I understand your frustrations. It seems so common for this situation with APS it is sad. I am currently stuck somewhere in between diagnosis & treatment. It's crazy. Early 20's PE 'Provoked' I have already tested positive twice for APS but when I was sent to the hemotologist he said I never should have been tested for it & took me off heparin when I was 6 weeks pregnant. I miscarried at 7 weeks. I'm pregnant again & I am 8 weeks but I just started with a backache, cramping & light bleeding Saturday night. :( it's not looking very good this time either. I don't want to go through this a few more times. I'm taking this article to my Dr tomorrow.

  • Hi Sassyone, yes I read your reply on my earlier question. Sounds like we're in a similar situation. I am really sorry to hear that your pregnancy is not looking good. I hope and pray that it doesn't end in another miscarriage. Its where I am scared off, only on aspirin now and if I get my gynae agreed on taking heparine, I have to wait till friday since here in Amsterdam they only seem to prescribe it after ultrasound with positive heart action. I hope I am not too late with it. I also have cramping this wknd, I just hope its a normal pregnancy symptom... Let me know how you're doing! And I hope this article I've found can help you too.

  • Well done on finding such a relevant article. I hopeyou get a good response from it. So sorry to hear that you are having all this worry too Sassyone. So sad to hear that you were taken off heparin in your l.ast pregnancy.. That must have been hard to deal with. I wonder if the doctors consider it risky even though it seems to be very safe. Good luck to both of you . Ann

  • My bad luck: I was talking to a doctor in residence, so not a qualified gyneacologist. She will again discuss my case coming thursday and will plead for heparine, but my gut feeling is that a residents doesn't have a very strong position to change the protocol of a hospital... Am considering to make an appointment with the local hospital who diagnosed me with the syndrom just in case...

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