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anticardiolipin antibodiesFrom: evita fernandez FRCOG (evitafmh@hd2.vsnl.net.in)Tue May 13 18:38:30 2003
Sometimes a patient registers for antenatal care at 18 weeks following a history of recurrent losses. Her history may be strongly suggestive of APA syndrome. Can she be tested for ACL antibodies and Lupus anticoagulant during pregnancy ?I understand the results may not reflect the correct picture when tested during pregnancy. And yet, I am hesitant to begin low molecular weight heparin therapy without confirming the diagnosis. Are we justifies in beginning low dose aspirin at least especially when one sees bilateral notches on a doppler flow study done at the time of registration at 18 weeks? Sometimes a patient who has had high levels of ACL antibodies and who has been treated with low mol wt heparin and has had a successful pregnancy , when tested in the next pregnancy has normal levels. How does one explain this? Is this possible? Following a succesful pregnancy with low mol wt heparin what is the follow up of these patients on a long term basis? Do we prescribe low dose aspirin for life? Do we recall on a yearly basis and check for hypertension????What advice do we give them?
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